Shen Andy A, Visoki Elina, Barzilay Ran, Pimentel Samuel D
Department of Statistics, University of California, Berkeley, California, USA.
Children's Hospital of Philadelphia, Pennsylvania, USA.
Stat Med. 2025 Feb 28;44(5):e70010. doi: 10.1002/sim.70010.
Disparities in health or well-being experienced by minority groups can be difficult to study using the traditional exposure-outcome paradigm in causal inference, since potential outcomes in variables such as race or sexual minority status are challenging to interpret. Causal decomposition analysis addresses this gap by positing causal effects on disparities under interventions to other intervenable exposures that may play a mediating role in the disparity. While invoking weaker assumptions than causal mediation approaches, decomposition analyses are often conducted in observational settings and require uncheckable assumptions that eliminate unmeasured confounders. Leveraging the marginal sensitivity model, we develop a sensitivity analysis for weighted causal decomposition estimators and use the percentile bootstrap to construct valid confidence intervals for causal effects on disparities. We also propose a two-parameter reformulation that enhances interpretability and facilitates an intuitive understanding of the plausibility of unmeasured confounders and their effects. We illustrate our framework on a study examining the effect of parental support on disparities in suicidal ideation among sexual minority youth. We find that the effect is small and sensitive to unmeasured confounding, suggesting that further screening studies are needed to identify mitigating interventions in this vulnerable population.
少数群体在健康或福祉方面存在的差异,使用因果推断中的传统暴露-结果范式进行研究可能会很困难,因为种族或性少数群体身份等变量中的潜在结果难以解释。因果分解分析通过假定对差异的因果效应,在干预措施下作用于其他可能在差异中起中介作用的可干预暴露,解决了这一差距。虽然分解分析比因果中介方法所采用的假设更弱,但通常是在观察性研究中进行,并且需要消除未测量混杂因素的无法检验的假设。利用边际敏感性模型,我们为加权因果分解估计量开发了一种敏感性分析,并使用百分位数自助法为差异的因果效应构建有效的置信区间。我们还提出了一种双参数重新表述方法,该方法增强了可解释性,并有助于直观理解未测量混杂因素的合理性及其影响。我们在一项研究中展示了我们的框架,该研究考察了父母支持对性少数青年自杀意念差异的影响。我们发现这种影响很小,并且对未测量的混杂因素很敏感,这表明需要进一步的筛查研究,以确定针对这一弱势群体的缓解干预措施。