Yang Chen, Cuerden Meaghan S, Zhang Wei, Aldridge Melissa, Li Lihua
Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Health Serv Outcomes Res Methodol. 2024 Sep;24(3):327-347. doi: 10.1007/s10742-023-00317-y. Epub 2023 Nov 18.
Propensity score methods have been widely adopted in observational studies, however research on propensity score-based weighting (PSW) methods in complex survey data settings is lacking, particularly for binary outcomes. We conducted a simulation study to compare eight propensity score weighting approaches for estimating treatment effects using survey weighted data. Each of the eight methods is applied to estimation of two measures of the population-level treatment effect: the population average treatment effect (PATE), and the population average treatment effect on the treated (PATT). The methods are compared in terms of mean relative bias and coverage probability under different scenarios by varying the treatment effect, degrees of model misspecification, and levels of overlap in the propensity score. The results demonstrate that the two-stage methods with predicted outcomes weighted by survey weights consistently outperform the other methods for estimating the PATT; for estimating the PATE, the best performing PSW method depends on the degree of model misspecification and propensity score overlap. When the outcome model is correctly specified, four two-stage methods produce better estimates depending on the propensity score overlap. The methods are applied to the 2015 National Health Interview Survey data to estimate the effect of provider-patient discussion about smoking on smoking cessation.
倾向得分方法已在观察性研究中广泛应用,然而,针对复杂调查数据环境下基于倾向得分的加权(PSW)方法的研究却很匮乏,尤其是对于二元结局而言。我们开展了一项模拟研究,以比较八种倾向得分加权方法在使用调查加权数据估计治疗效果方面的表现。这八种方法中的每一种都应用于估计总体水平治疗效果的两种指标:总体平均治疗效果(PATE)和治疗对象的总体平均治疗效果(PATT)。通过改变治疗效果、模型误设程度和倾向得分的重叠水平,在不同场景下根据平均相对偏差和覆盖概率对这些方法进行比较。结果表明,对于估计PATT,采用调查权重对预测结果进行加权的两阶段方法始终优于其他方法;对于估计PATE,表现最佳的PSW方法取决于模型误设程度和倾向得分重叠情况。当结局模型正确设定时,根据倾向得分重叠情况,四种两阶段方法能得出更好的估计值。这些方法应用于2015年国家健康访谈调查数据,以估计医患关于吸烟的讨论对戒烟的影响。