arXivDaily arXiv每日学术速递 周一至周五更新
arXiv 2405.07186stat.MEstat.ML
收藏

自适应目标最大似然估计:基于真实世界数据增强的随机对照试验中的平均处理效应估计

Adaptive-TMLE for the Average Treatment Effect based on Randomized Controlled Trial Augmented with Real-World Data

Mark van der Laan, Sky Qiu, Jens Magelund Tarp, Lars van der Laan

AI总结:

提出自适应目标最大似然估计(A-TMLE)框架,利用真实世界数据增强随机对照试验以估计平均处理效应,在保证一致性和渐近正态性的同时实现超效率,提升试验效能并缩短试验周期。

摘要:

我们考虑在同时拥有随机对照试验(RCT)数据和外部真实世界数据(RWD)的情况下,估计平均处理效应(ATE)的问题。我们将ATE估计量分解为两部分之差:一个整合了RCT和RWD的合并ATE估计量,以及一个捕捉RCT入组对结局的条件效应的偏倚估计量。我们引入了一种自适应目标最大似然估计(A-TMLE)框架来估计它们。我们证明了A-TMLE估计量是根号n一致的且渐近正态的。此外,在有限样本中,它达到了若已知RCT入组对结局的条件效应的真实模型时所能够获得的超效率。因此,由RWD引起的偏倚的工作模型越小且越简洁,我们估计量的效率就越高,同时我们的估计量将始终至少与仅使用RCT数据的有效估计量一样有效。在模拟中,A-TMLE通过更小的均方误差和95%置信区间优于现有方法。我们将A-TMLE应用于使用Optum Clinformatics Data Mart的外部数据增强DEVOTE试验,展示了其在非劣效性试验中确立治疗优效性的潜力。A-TMLE可以利用外部RWD来提高随机试验的效能,而不会使干预效应的估计产生偏倚。这种方法可以支持更小、更快的试验,缩短患者获得有效治疗的时间。

英文摘要:

We consider the problem of estimating the average treatment effect (ATE) when both randomized control trial (RCT) data and external real-world data (RWD) are available. We decompose the ATE estimand as the difference between a pooled-ATE estimand that integrates RCT and RWD and a bias estimand that captures the conditional effect of RCT enrollment on the outcome. We introduce an adaptive targeted maximum likelihood estimation (A-TMLE) framework to estimate them. We prove that the A-TMLE estimator is root-n-consistent and asymptotically normal. Moreover, in finite sample, it achieves the super-efficiency one would obtain had one known the oracle model for the conditional effect of the RCT enrollment on the outcome. Consequently, the smaller and more parsimonious the working model of the bias induced by the RWD is, the greater our estimator's efficiency, while our estimator will always be at least as efficient as an efficient estimator that uses the RCT data only. A-TMLE outperforms existing methods in simulations by having smaller mean-squared-error and 95% confidence intervals. We apply A-TMLE to augment the DEVOTE trial with external data from the Optum Clinformatics Data Mart, demonstrating its potential to establish treatment superiority in noninferiority trials. A-TMLE could utilize external RWD to help improve the power of randomized trials without biasing the estimates of intervention effects. This approach could allow for smaller, faster trials, decreasing the time until patients can receive effective treatments.

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

↑