Lok Judith J
Department of Biostatistics, Harvard School of Public Health.
Ann Stat. 2017 Apr;45(2):461-499. doi: 10.1214/15-AOS1433. Epub 2017 May 16.
In observational studies, treatment may be adapted to covariates at several times without a fixed protocol, in continuous time. Treatment influences covariates, which influence treatment, which influences covariates, and so on. Then even time-dependent Cox-models cannot be used to estimate the net treatment effect. Structural nested models have been applied in this setting. Structural nested models are based on counterfactuals: the outcome a person would have had had treatment been withheld after a certain time. Previous work on continuous-time structural nested models assumes that counterfactuals depend deterministically on observed data, while conjecturing that this assumption can be relaxed. This article proves that one can mimic counterfactuals by constructing random variables, solutions to a differential equation, that have the same distribution as the counterfactuals, even given past observed data. These "mimicking" variables can be used to estimate the parameters of structural nested models without assuming the treatment effect to be deterministic.
在观察性研究中,治疗可能会在连续时间内多次根据协变量进行调整,而没有固定的方案。治疗会影响协变量,协变量又会影响治疗,治疗又会影响协变量,如此循环往复。那么,即使是时间相依的Cox模型也无法用于估计净治疗效果。结构嵌套模型已应用于这种情况。结构嵌套模型基于反事实:一个人在某一时刻之后若不接受治疗会出现的结果。先前关于连续时间结构嵌套模型的研究假设反事实完全取决于观测数据,同时推测这个假设可以放宽。本文证明,即使给定过去的观测数据,也可以通过构建与反事实具有相同分布的随机变量(一个微分方程的解)来模拟反事实。这些“模拟”变量可用于估计结构嵌套模型的参数,而无需假设治疗效果是确定性的。