论文标题
在观察研究中,匹配的边际因果效应对限制的平均生存时间的匹配设计
Matched Design for Marginal Causal Effect on Restricted Mean Survival Time in Observational Studies
论文作者
论文摘要
研究暴露与事件时间结果之间的因果关系是生物医学研究中的一个重要主题。先前的文献已经讨论了由于其非挑战性属性,将危险比用作边际因果关系措施的潜在问题。在本文中,我们提倡使用受限的平均生存时间(RMST)作为边际因果效应度量,这是可折叠的,并且简单地解释为在特定时间范围内生存曲线下面积的差异。为了解决测量和未衡量的混杂,提出了具有灵敏度分析的匹配设计。匹配用于将类似的处理和未经处理的受试者配对,这对于结果模型错误指定更强大。我们的倾向得分匹配的RMST差估计量被证明是渐近的无偏见,并且通过考虑匹配引起的相关性来计算相应的方差估计器。仿真研究还表明,我们的方法具有足够的经验性能,并且优于实践中使用的许多竞争方法。为了评估未衡量的混杂的影响,我们通过调整电子价值方法来制定灵敏度分析策略。我们将提出的方法应用于社区研究(ARIC)中的动脉粥样硬化风险,以检查吸烟对无中风生存的因果作用。
Investigating the causal relationship between exposure and the time-to-event outcome is an important topic in biomedical research. Previous literature has discussed the potential issues of using the hazard ratio as a marginal causal effect measure due to its noncollapsibility property. In this paper, we advocate using the restricted mean survival time (RMST) difference as the marginal causal effect measure, which is collapsible and has a simple interpretation as the difference of area under survival curves over a certain time horizon. To address both measured and unmeasured confounding, a matched design with sensitivity analysis is proposed. Matching is used to pair similar treated and untreated subjects together, which is more robust to outcome model misspecification. Our propensity score matched RMST difference estimator is shown to be asymptotically unbiased and the corresponding variance estimator is calculated by accounting for the correlation due to matching. The simulation study also demonstrates that our method has adequate empirical performance and outperforms many competing methods used in practice. To assess the impact of unmeasured confounding, we develop a sensitivity analysis strategy by adapting the E-value approach to matched data. We apply the proposed method to the Atherosclerosis Risk in Communities Study (ARIC) to examine the causal effect of smoking on stroke-free survival.