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arXiv 2602.12682stat.ME
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量化剩余生存时间的因果框架

A Causal Framework for Quantile Residual Lifetime

U.S. Food and Drug Administration(美国食品药品监督管理局);Konkuk University(建国大学);Duke University(杜克大学);National Cancer Institute(美国国家癌症研究所)

Taekwon Hong, Woojung Bae, Sang Kyu Lee, Dongrak Choi, Jong-Hyeon Jeong

AI总结:

本文提出了一种因果框架,用于估计经历特定时间点后存活个体的剩余生存时间分位数,通过双重稳健估计器和补充估计器分离因果效应与选择偏差。

摘要:

在临床研究中,估计在经历初始高风险期后存活的预后至关重要。然而,标准指标如危险比通常难以解释,而基于均值的总结对异常值和删失敏感。我们提出了一种正式的因果框架,用于估计在经历里程碑时间t₀后存活个体的剩余生存时间的分位数。我们的主要估计量,

英文摘要:

Estimating prognosis conditional on surviving an initial high-risk period is crucial in clinical research. Yet, standard metrics such as hazard ratios are often difficult to interpret, while mean-based summaries are sensitive to outliers and censoring. We propose a formal causal framework for estimating quantiles of residual lifetime among individuals surviving to a landmark time $t_0$. Our primary estimand, the "Observed Survivor Quantile Contrast" (OSQC), targets pragmatic prognostic differences within the observed survivor population. To estimate the OSQC, we develop a doubly robust estimator that combines propensity scores, outcome regression, and inverse probability of censoring weights, ensuring consistency under confounding and informative censoring provided that the censoring model is correctly specified and at least one additional nuisance model is correctly specified. Recognizing that the OSQC conflates causal efficacy and compositional selection, we also introduce a reweighting-based supplementary estimator for the "Principal Survivor Quantile Contrast" (PSQC) to disentangle these mechanisms under stronger assumptions. Extensive simulations demonstrate the robustness of the proposed estimators and clarify the role of post-treatment selection. We illustrate the framework using data from the SUPPORT study to assess the impact of right heart catheterization on residual lifetime among intensive care unit survivors, and from the NSABP B-14 trial to examine post-surgical prognosis under adjuvant tamoxifen therapy across multiple landmark times.

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。

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