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We present a practical guide for the analysis of regression discontinuity (RD) designs in biomedical contexts. We begin by introducing key concepts, assumptions, and estimands within both the continuity‐based framework and the local randomization framework. We then discuss modern estimation and inference methods within both frameworks, including approaches for bandwidth or local neighborhood selection, optimal treatment effect point estimation, and robust bias‐corrected inference methods for uncertainty quantification. We also overview empirical falsification tests that can be used to support key assumptions. Our discussion focuses on two particular features that are relevant in biomedical research: (i) fuzzy RD designs, which often arise when therapeutic treatments are based on clinical guidelines, but patients with scores near the cutoff are treated contrary to the assignment rule; and (ii) RD designs with discrete scores, which are ubiquitous in biomedical applications. We illustrate our discussion with three empirical applications: the effect CD4 guidelines for anti‐retroviral therapy on retention of HIV patients in South Africa, the effect of genetic guidelines for chemotherapy on breast cancer recurrence in the United States, and the effects of age‐based patient cost‐sharing on healthcare utilization in Taiwan. Complete replication materials employing publicly available data and statistical software inPython,RandStataare provided, offering researchers all necessary tools to conduct an RD analysis.
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Regression Discontinuity Designs
The regression discontinuity (RD) design is one of the most widely used nonexperimental methods for causal inference and program evaluation. Over the last two decades, statistical and econometric methods for RD analysis have expanded and matured, and there is now a large number of methodological results for RD identification, estimation, inference, and validation. We offer a curated review of this methodological literature organized around the two most popular frameworks for the analysis and interpretation of RD designs: the continuity framework and the local randomization framework. For each framework, we discuss three main topics: ( a) designs and parameters, focusing on different types of RD settings and treatment effects of interest; ( b) estimation and inference, presenting the most popular methods based on local polynomial regression and methods for the analysis of experiments, as well as refinements, extensions, and alternatives; and ( c) validation and falsification, summarizing an array of mostly empirical approaches to support the validity of RD designs in practice.
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- PAR ID:
- 10417606
- Date Published:
- Journal Name:
- Annual Review of Economics
- Volume:
- 14
- Issue:
- 1
- ISSN:
- 1941-1383
- Page Range / eLocation ID:
- 821 to 851
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
-
Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.1146/annurev-economics-051520-021409
