School of Health and Social Care, University of Essex, Colchester, CO4 3SQ, UK.
Department of Economics, University of Exeter, Exeter, EX4 4PU, UK.
Sci Rep. 2024 Sep 30;14(1):22606. doi: 10.1038/s41598-024-73714-z.
Large-scale Randomised Controlled Trials (RCTs) are widely regarded as "the gold standard" for testing the causal effects of school-based interventions. RCTs typically present the statistical significance of the average treatment effect (ATE), which captures the effect an intervention has had on average for a given population. However, key decisions in child health and education are often about individuals who may be very different from those averages. One way to identify heterogeneous treatment effects across different individuals, not captured by the ATE, is to conduct subgroup analyses. For example, free school meal (FSM) pupils as required for projects funded by the Education Endowment Foundation (EEF) in England. These subgroup analyses, as we demonstrate in 48 EEF-funded RCTs involving over 200,000 students, are usually not standardised across studies and offer flexible degrees of freedom to researchers, potentially leading to mixed, if not misleading, results. Here, we develop and deploy an alternative to ATE and subgroup analysis, a machine-learning and regression-based framework to predict individualised treatment effects (ITEs). ITEs could show where an intervention worked, for which individuals, and to what extent. Our findings have implications for decision-makers in fields like education, healthcare, law, and clinical practices concerning children and adolescents.
大规模随机对照试验(RCT)被广泛认为是检验基于学校的干预措施因果效应的“金标准”。RCT 通常呈现平均处理效应(ATE)的统计显著性,该效应捕捉了干预措施对特定人群的平均影响。然而,儿童健康和教育方面的关键决策通常涉及可能与平均值大不相同的个体。一种识别 ATE 无法捕捉的不同个体之间异质处理效应的方法是进行亚组分析。例如,英格兰教育基金会(EEF)资助项目中的免费学校餐(FSM)学生。正如我们在涉及超过 20 万名学生的 48 项 EEF 资助 RCT 中所展示的那样,这些亚组分析通常在研究之间没有标准化,为研究人员提供了灵活的自由度,可能导致混合的、甚至是误导性的结果。在这里,我们开发并部署了一种替代 ATE 和亚组分析的方法,即基于机器学习和回归的个体化治疗效果(ITE)预测框架。ITE 可以显示干预措施在何处、对哪些个体以及在何种程度上有效。我们的研究结果对教育、医疗保健、法律和临床实践等领域的决策者对儿童和青少年的决策具有重要意义。