Propensity score modelling in observational studies using dimension reduction methods.
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ABSTRACT:
SUBMITTER: Ghosh D
PROVIDER: S-EPMC3099445 | biostudies-literature | 2011 Jul
REPOSITORIES: biostudies-literature
Publications
Propensity score modelling in observational studies using dimension reduction methods.
Statistics & probability letters 20110701 7
Conditional independence assumptions are very important in causal inference modelling as well as in dimension reduction methodologies. These are two very strikingly different statistical literatures, and we study links between the two in this article. The concept of covariate sufficiency plays an important role, and we provide theoretical justification when dimension reduction and partial least squares methods will allow for valid causal inference to be performed. The methods are illustrated wit ...[more]
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Project description:AimsRandomized controlled trials (RCTs) are the gold standard for assessing the efficacy of therapeutic interventions because randomization protects from biases inherent in observational studies. Propensity score (PS) methods, proposed as a potential solution to confounding of the treatment-outcome association, are widely used in observational studies of therapeutic interventions for acute coronary syndromes (ACS). We aimed to systematically assess agreement between observational studies using PS methods and RCTs on therapeutic interventions for ACS.Methods and resultsWe searched for observational studies of interventions for ACS that used PS methods to estimate treatment effects on short- or long-term mortality. Using a standardized algorithm, we matched observational studies to RCTs based on patients' characteristics, interventions, and outcomes ('topics'), and we compared estimates of treatment effect between the two designs. When multiple observational studies or RCTs were identified for the same topic, we performed a meta-analysis and used the summary relative risk for comparisons. We matched 21 observational studies investigating 17 distinct clinical topics to 63 RCTs (median = 3 RCTs per observational study) for short-term (7 topics) and long-term (10 topics) mortality. Estimates from PS analyses differed statistically significantly from randomized evidence in two instances; however, observational studies reported more extreme beneficial treatment effects compared with RCTs in 13 of 17 instances (P = 0.049). Sensitivity analyses limited to large RCTs, and using alternative meta-analysis models yielded similar results.ConclusionFor the treatment of ACS, observational studies using PS methods produce treatment effect estimates that are of more extreme magnitude compared with those from RCTs, although the differences are rarely statistically significant.
| S-EPMC3409422 | biostudies-literature
Project description:BackgroundObservational analysis methods can be refined by benchmarking against randomized trials. We reviewed studies systematically comparing observational analyses using propensity score methods against randomized trials to explore whether intervention or outcome characteristics predict agreement between designs.MethodsWe searched PubMed (from January 1, 2000, to April 30, 2017), the AHRQ Scientific Resource Center Methods Library, reference lists, and bibliographies to identify systematic reviews that compared estimates from observational analyses using propensity scores against randomized trials across three or more clinical topics; reported extractable relative risk (RR) data; and were published in English. One reviewer extracted data from all eligible systematic reviews; a second reviewer verified the extracted data.ResultsSix systematic reviews matching published observational studies to randomized trials, published between 2012 and 2016, met our inclusion criteria. The reviews reported on 127 comparisons overall, in cardiology (29 comparisons), surgery (49), critical care medicine and sepsis (46), nephrology (2), and oncology (1). Disagreements were large (relative RR < 0.7 or > 1.43) in 68 (54%) and statistically significant in 12 (9%) of the comparisons. The degree of agreement varied among reviews but was not strongly associated with intervention or outcome characteristics.DiscussionDisagreements between observational studies using propensity score methods and randomized trials can occur for many reasons and the available data cannot be used to discern the reasons behind specific disagreements. Better benchmarking of observational analyses using propensity scores (and other causal inference methods) is possible using observational studies that explicitly attempt to emulate target trials.
| S-EPMC7210373 | biostudies-literature
Project description:Non-potassium-sparing diuretics are commonly used in heart failure (HF). They activate the neurohormonal system, and are potentially harmful. Yet, the long-term effects of chronic diuretic use in HF are largely unknown. We retrospectively analysed the Digitalis Investigation Group (DIG) data to determine the effects of diuretics on HF outcomes.Propensity scores for diuretic use were calculated for each of the 7788 DIG participants using a non-parsimonious multivariable logistic regression model, and were used to match 1391 (81%) no-diuretic patients with 1391 diuretic patients. Effects of diuretics on mortality and hospitalization at 40 months of median follow-up were assessed using matched Cox regression models. All-cause mortality was 21% for no-diuretic patients and 29% for diuretic patients [hazard ratio (HR) 1.31; 95% confidence interval (CI) 1.11-1.55; P = 0.002]. HF hospitalizations occurred in 18% of no-diuretic patients and 23% of diuretic patients (HR 1.37; 95% CI 1.13-1.65; P = 0.001).Chronic diuretic use was associated with increased long-term mortality and hospitalizations in a wide spectrum of ambulatory chronic systolic and diastolic HF patients. The findings of the current study challenge the wisdom of routine chronic use of diuretics in HF patients who are asymptomatic or minimally symptomatic without fluid retention, and are on complete neurohormonal blockade. These findings, based on a non-randomized design, need to be further studied in randomized trials.
| S-EPMC2443408 | biostudies-other
Project description:ObjectiveTo provide a tutorial for using propensity score methods with complex survey data.Data sourcesSimulated data and the 2008 Medical Expenditure Panel Survey.Study designUsing simulation, we compared the following methods for estimating the treatment effect: a naïve estimate (ignoring both survey weights and propensity scores), survey weighting, propensity score methods (nearest neighbor matching, weighting, and subclassification), and propensity score methods in combination with survey weighting. Methods are compared in terms of bias and 95 percent confidence interval coverage. In Example 2, we used these methods to estimate the effect on health care spending of having a generalist versus a specialist as a usual source of care.Principal findingsIn general, combining a propensity score method and survey weighting is necessary to achieve unbiased treatment effect estimates that are generalizable to the original survey target population.ConclusionsPropensity score methods are an essential tool for addressing confounding in observational studies. Ignoring survey weights may lead to results that are not generalizable to the survey target population. This paper clarifies the appropriate inferences for different propensity score methods and suggests guidelines for selecting an appropriate propensity score method based on a researcher's goal.
| S-EPMC3894255 | biostudies-literature
Project description:Existing studies have suggested superior performance of nonparametric machine learning over logistic regression for propensity score estimation. However, it is unclear whether the advantages of nonparametric propensity score modeling are carried to settings where there is clustering of individuals, especially when there is unmeasured cluster-level confounding. In this work we examined the performance of logistic regression (all main effects), Bayesian additive regression trees and generalized boosted modeling for propensity score weighting in clustered settings, with the clustering being accounted for by including either cluster indicators or random intercepts. We simulated data for three hypothetical observational studies of varying sample and cluster sizes. Confounders were generated at both levels, including a cluster-level confounder that is unobserved in the analyses. A binary treatment and a continuous outcome were generated based on seven scenarios with varying relationships between the treatment and confounders (linear and additive, nonlinear/nonadditive, nonadditive with the unobserved cluster-level confounder). Results suggest that when the sample and cluster sizes are large, nonparametric propensity score estimation may provide better covariate balance, bias reduction, and 95% confidence interval coverage, regardless of the degree of nonlinearity or nonadditivity in the true propensity score model. When the sample or cluster sizes are small, however, nonparametric approaches may become more vulnerable to unmeasured cluster-level confounding and thus may not be a better alternative to multilevel logistic regression. We applied the methods to the National Longitudinal Study of Adolescent to Adult Health data, estimating the effect of team sports participation during adolescence on adulthood depressive symptoms.
| S-EPMC9996644 | biostudies-literature
Project description:Observational studies in glaucoma patients can provide important evidence on treatment effects, especially for combination therapies which are often used in reality. But the success relies on the reduction of selection bias through methods such as propensity score (PS) weighting. The objective of this study was to assess the effects of five glaucoma treatments (medication, laser, non-laser surgery (NLS), laser + medication, and NLS + medication) on 1-year intraocular pressure (IOP) change. Data were collected from 90 glaucoma subjects who underwent a single laser, or NLS intervention, and/or took the same medication for at least 6 months, and had IOP measures before the treatment and 12-months after. Baseline IOP was significantly different across groups (p = 0.007) and this unbalance was successfully corrected by the PS weighting (p = 0.81). All groups showed statistically significant PS-weighted IOP reductions, with the largest reduction in NLS group (-6.78 mmHg). Baseline IOP significantly interacted with treatments (p = 0.03), and at high baseline IOP medication was less effective than other treatments. Our findings showed that the 1-year IOP reduction differed across treatment groups and was dependent on baseline IOP. The use of PS-weighted methods reduced treatment selection bias at baseline and allowed valid assessment of the treatment effect in an observational study.
| S-EPMC6820863 | biostudies-other
Project description:PrecisThe exclusion of unmatched observations in propensity score matching has implications for the generalizability of causal effects. Machine learning methods can help to identify how the study population differs from the unmatched subpopulation.BackgroundThere has been widespread use of propensity scores in evaluating the effect of cancer treatments on survival, particularly in administrative databases and cancer registries. A byproduct of certain matching schemes is the exclusion of observations. Borrowing an analogy from clinical trials, one can view these exclusions as subjects that do not satisfy eligibility criteria.MethodsDeveloping identification rules for these "data-driven eligibility criteria" in observational studies on both population and individual levels helps to ascertain the population on which causal effects are being made. This article presents a machine learning method to determine the representativeness of causal effects in two different datasets from the National Cancer Database.ResultsDecision trees reveal that groups with certain features have a higher probability of inclusion in the study population than older patients. In the first dataset, younger age categories had an inclusion probability of at least 0.90 in all models, while the probability for the older category ranged from 0.47 to 0.65. Most trees split once more on an even higher age at a lower node, suggesting that the oldest patients are the least likely to be matched. In the second set of data, both age and surgery status were associated with inclusion.ConclusionThe methodology presented in this paper underscores the need to consider exclusions in propensity score matching procedures as well as complementing matching with other propensity score adjustments.
| S-EPMC9630947 | biostudies-literature
Project description:BackgroundThe most popular methods for significance analysis on microarray data are well suited to find genes differentially expressed across predefined categories. However, identification of features that correlate with continuous dependent variables is more difficult using these methods, and long lists of significant genes returned are not easily probed for co-regulations and dependencies. Dimension reduction methods are much used in the microarray literature for classification or for obtaining low-dimensional representations of data sets. These methods have an additional interpretation strength that is often not fully exploited when expression data are analysed. In addition, significance analysis may be performed directly on the model parameters to find genes that are important for any number of categorical or continuous responses. We introduce a general scheme for analysis of expression data that combines significance testing with the interpretative advantages of the dimension reduction methods. This approach is applicable both for explorative analysis and for classification and regression problems.ResultsThree public data sets are analysed. One is used for classification, one contains spiked-in transcripts of known concentrations, and one represents a regression problem with several measured responses. Model-based significance analysis is performed using a modified version of Hotelling's T2-test, and a false discovery rate significance level is estimated by resampling. Our results show that underlying biological phenomena and unknown relationships in the data can be detected by a simple visual interpretation of the model parameters. It is also found that measured phenotypic responses may model the expression data more accurately than if the design-parameters are used as input. For the classification data, our method finds much the same genes as the standard methods, in addition to some extra which are shown to be biologically relevant. The list of spiked-in genes is also reproduced with high accuracy.ConclusionThe dimension reduction methods are versatile tools that may also be used for significance testing. Visual inspection of model components is useful for interpretation, and the methodology is the same whether the goal is classification, prediction of responses, feature selection or exploration of a data set. The presented framework is conceptually and algorithmically simple, and a Matlab toolbox (Mathworks Inc, USA) is supplemented.
| S-EPMC2194745 | biostudies-literature
Project description:We propose counting process-based dimension reduction methods for right-censored survival data. Semiparametric estimating equations are constructed to estimate the dimension reduction subspace for the failure time model. Our methods address two limitations of existing approaches. First, using the counting process formulation, they do not require estimation of the censoring distribution to compensate for the bias in estimating the dimension reduction subspace. Second, the nonparametric estimation involved adapts to the structural dimension, so our methods circumvent the curse of dimensionality. Asymptotic normality is established for the estimators. We propose a computationally efficient approach that requires only a singular value decomposition to estimate the dimension reduction subspace. Numerical studies suggest that our new approaches exhibit significantly improved performance. The methods are implemented in the [Formula: see text] package [Formula: see text].
| S-EPMC6373420 | biostudies-literature
Project description:Continuous treatments propensity scoring remains understudied as the majority of methods are focused on the binary treatment setting. Current propensity score methods for continuous treatments typically rely on weighting in order to produce causal estimates. It has been shown that in some continuous treatment settings, weighting methods can result in worse covariate balance than had no adjustments been made to the data. Furthermore, weighting is not always stable, and resultant estimates may be unreliable due to extreme weights. These issues motivate the current development of novel propensity score stratification techniques to be used with continuous treatments. Specifically, the generalized propensity score cumulative distribution function (GPS-CDF) and the nonparametric GPS-CDF approaches are introduced. Empirical CDFs are used to stratify subjects based on pretreatment confounders in order to produce causal estimates. A detailed simulation study shows superiority of these new stratification methods based on the empirical CDF, when compared with standard weighting techniques. The proposed methods are applied to the "Mexican-American Tobacco use in Children" study to determine the causal relationship between continuous exposure to smoking imagery in movies, and smoking behavior among Mexican-American adolescents. These promising results provide investigators with new options for implementing continuous treatment propensity scoring.
| S-EPMC8629138 | biostudies-literature