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Abstract Propensity score weighting is a tool for causal inference to adjust for measured confounders in observational studies. In practice, data often present complex structures, such as clustering, which make propensity score modeling and estimation challenging. In addition, for clustered data, there may be unmeasured cluster-level covariates that are related to both the treatment assignment and outcome. When such unmeasured cluster-specific confounders exist and are omitted in the propensity score model, the subsequent propensity score adjustment may be biased. In this article, we propose a calibration technique for propensity score estimation under the latent ignorable treatment assignment mechanism, i. e., the treatment-outcome relationship is unconfounded given the observed covariates and the latent cluster-specific confounders. We impose novel balance constraints which imply exact balance of the observed confounders and the unobserved cluster-level confounders between the treatment groups. We show that the proposed calibrated propensity score weighting estimator is doubly robust in that it is consistent for the average treatment effect if either the propensity score model is correctly specified or the outcome follows a linear mixed effects model. Moreover, the proposed weighting method can be combined with sampling weights for an integrated solution to handle confounding and sampling designs for causal inference with clustered survey data. In simulation studies, we show that the proposed estimator is superior to other competitors. We estimate the effect of School Body Mass Index Screening on prevalence of overweight and obesity for elementary schools in Pennsylvania.
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Propensity Score Modeling in Electronic Health Records with Time-to-Event Endpoints: Application to Kidney Transplantation
For large observational studies lacking a control group (unlike randomized controlled trials, RCT), propensity scores (PS) are often the method of choice to account for pre-treatment confounding in baseline characteristics, and thereby avoid substantial bias in treatment estimation. A vast majority of PS techniques focus on average treatment effect estimation, without any clear consensus on how to account for confounders, especially in a multiple treatment setting. Furthermore, for time-to event outcomes, the analytical framework is further complicated in presence of high censoring rates (sometimes, due to non-susceptibility of study units to a disease), imbalance between treatment groups, and clustered nature of the data (where, survival outcomes appear in groups). Motivated by a right-censored kidney transplantation dataset derived from the United Network of Organ Sharing (UNOS), we investigate and compare two recent promising PS procedures, (a) the generalized boosted model (GBM), and (b) the covariate-balancing propensity score (CBPS), in an attempt to decouple the causal effects of treatments (here, study subgroups, such as hepatitis C virus (HCV) positive/negative donors, and positive/negative recipients) on time to death of kidney recipients due to kidney failure, post transplantation. For estimation, we employ a 2-step procedure which addresses various complexities observed in the UNOS database within a unified paradigm. First, to adjust for the large number of confounders on the multiple sub-groups, we fit multinomial PS models via procedures (a) and (b). In the next stage, the estimated PS is incorporated into the likelihood of a semi-parametric cure rate Cox proportional hazard frailty model via inverse probability of treatment weighting, adjusted for multi-center clustering and excess censoring, Our data analysis reveals a more informative and superior performance of the full model in terms of treatment effect estimation, over sub-models that relaxes the various features of the event time dataset.
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- Award ID(s):
- 1811245
- PAR ID:
- 10337419
- Date Published:
- Journal Name:
- Journal of Data Science
- ISSN:
- 1680-743X
- Page Range / eLocation ID:
- 188 to 208
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.6339/22-JDS1046
