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Dynamic Treatment Effects.

ABSTRACT: This paper develops robust models for estimating and interpreting treatment effects arising from both ordered and unordered multistage decision problems. Identification is secured through instrumental variables and/or conditional independence (matching) assumptions. We decompose treatment effects into direct effects and continuation values associated with moving to the next stage of a decision problem. Using our framework, we decompose the IV estimator, showing that IV generally does not estimate economically interpretable or policy relevant parameters in prototypical dynamic discrete choice models, unless policy variables are instruments. Continuation values are an empirically important component of estimated total treatment effects of education. We use our analysis to estimate the components of what LATE estimates in a dynamic discrete choice model.

SUBMITTER: Heckman JJ

PROVIDER: S-EPMC4815275 | biostudies-literature | 2016 Feb

REPOSITORIES: biostudies-literature

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Dynamic Treatment Effects.

Heckman James J JJ Humphries John Eric JE Veramendi Gregory G

Journal of econometrics 20160201 2

This paper develops robust models for estimating and interpreting treatment effects arising from both ordered and unordered multistage decision problems. Identification is secured through instrumental variables and/or conditional independence (matching) assumptions. We decompose treatment effects into direct effects and continuation values associated with moving to the next stage of a decision problem. Using our framework, we decompose the IV estimator, showing that IV generally does not estimat ...[more]

PMID: 27041793

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Project description:Precision medicine is currently a topic of great interest in clinical and intervention science. A key component of precision medicine is that it is evidence-based, i.e., data-driven, and consequently there has been tremendous interest in estimation of precision medicine strategies using observational or randomized study data. One way to formalize precision medicine is through a treatment regime, which is a sequence of decision rules, one per stage of clinical intervention, that map up-to-date patient information to a recommended treatment. An optimal treatment regime is defined as maximizing the mean of some cumulative clinical outcome if applied to a population of interest. It is well-known that even under simple generative models an optimal treatment regime can be a highly nonlinear function of patient information. Consequently, a focal point of recent methodological research has been the development of flexible models for estimating optimal treatment regimes. However, in many settings, estimation of an optimal treatment regime is an exploratory analysis intended to generate new hypotheses for subsequent research and not to directly dictate treatment to new patients. In such settings, an estimated treatment regime that is interpretable in a domain context may be of greater value than an unintelligible treatment regime built using 'black-box' estimation methods. We propose an estimator of an optimal treatment regime composed of a sequence of decision rules, each expressible as a list of "if-then" statements that can be presented as either a paragraph or as a simple flowchart that is immediately interpretable to domain experts. The discreteness of these lists precludes smooth, i.e., gradient-based, methods of estimation and leads to non-standard asymptotics. Nevertheless, we provide a computationally efficient estimation algorithm, prove consistency of the proposed estimator, and derive rates of convergence. We illustrate the proposed methods using a series of simulation examples and application to data from a sequential clinical trial on bipolar disorder.

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Dynamic Treatment Effects.

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Dynamic Treatment Effects.

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