Liu Kuan, Saarela Olli, Tomlinson George, Feldman Brian M, Pullenayegum Eleanor
Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Stat Methods Med Res. 2025 Jan;34(1):55-68. doi: 10.1177/09622802241298704. Epub 2024 Dec 12.
Bayesian methods are becoming increasingly in demand in clinical and public health comparative effectiveness research. Limited literature has explored parametric Bayesian causal approaches to handle time-dependent treatment and time-dependent covariates. In this article, building on to the work on Bayesian g-computation, we propose a fully Bayesian causal approach, implemented using latent confounder classes which represent the patient's disease and health status. Our setting is suitable when the latent class represents a true disease state that the physician is able to infer without misclassification based on manifest variables. We consider a causal effect that is confounded by the visit-specific latent class in a longitudinal setting and formulate the joint likelihood of the treatment, outcome and latent class models conditionally on the class indicators. The proposed causal structure with latent classes features dimension reduction of time-dependent confounders. We examine the performance of the proposed method using simulation studies and compare the proposed method to other causal methods for longitudinal data with time-dependent treatment and time-dependent confounding. Our approach is illustrated through a study of the effectiveness of intravenous immunoglobulin in treating newly diagnosed juvenile dermatomyositis.
贝叶斯方法在临床和公共卫生比较效果研究中的需求日益增加。有限的文献探讨了参数贝叶斯因果方法来处理随时间变化的治疗和随时间变化的协变量。在本文中,基于贝叶斯g计算的工作,我们提出了一种完全贝叶斯因果方法,该方法通过代表患者疾病和健康状况的潜在混杂因素类别来实现。当潜在类别代表医生能够根据显性变量无误分类推断出的真实疾病状态时,我们的设定是合适的。我们考虑在纵向环境中由特定访视的潜在类别混淆的因果效应,并根据类别指标制定治疗、结局和潜在类别模型的联合似然性。所提出的具有潜在类别的因果结构具有减少随时间变化的混杂因素维度的特点。我们使用模拟研究检验了所提出方法的性能,并将所提出的方法与其他用于具有随时间变化的治疗和随时间变化的混杂因素的纵向数据的因果方法进行了比较。通过一项关于静脉注射免疫球蛋白治疗新诊断的青少年皮肌炎有效性的研究来说明我们的方法。