Pharmacie, Université de Montréal, 2940, chemin de la Polytechnique, Montreal, QC, H3C 3J7, Canada.
Faculté de pharmacie, Université de Montréal, Pavillon Jean-Coutu, 2940 ch de la Polytechnique, Office #2236, Montreal, QC, Canada.
Int J Biostat. 2022 Jan 4;18(2):307-327. doi: 10.1515/ijb-2020-0073. eCollection 2022 Nov 1.
Effect modification occurs when the effect of a treatment on an outcome differsaccording to the level of some pre-treatment variable (the effect modifier). Assessing an effect modifier is not a straight-forward task even for a subject matter expert. In this paper, we propose a two-stageprocedure to automatically selecteffect modifying variables in a Marginal Structural Model (MSM) with a single time point exposure based on the two nuisance quantities (the conditionaloutcome expectation and propensity score). We highlight the performance of our proposal in a simulation study. Finally, to illustrate tractability of our proposed methods, we apply them to analyze a set of pregnancy data. We estimate the conditional expected difference in the counterfactual birth weight if all women were exposed to inhaled corticosteroids during pregnancy versus the counterfactual birthweight if all women were not, using data from asthma medications during pregnancy.
当一种治疗方法对某一结局的效果因某种治疗前变量(效应修饰因子)的水平而异时,就会发生效应修饰。即使对于医学专家来说,评估效应修饰因子也不是一项简单的任务。在本文中,我们提出了一种两阶段的方法,基于两个干扰量(条件结局期望和倾向评分),在具有单点暴露的边缘结构模型(MSM)中自动选择效应修饰变量。我们在模拟研究中强调了我们的建议的性能。最后,为了说明我们提出的方法的可操作性,我们将其应用于分析一组妊娠数据。我们使用来自怀孕期间使用的哮喘药物的数据,估计如果所有女性在怀孕期间都吸入皮质类固醇与所有女性都不吸入皮质类固醇相比,反事实出生体重的条件期望差异。