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Accommodating unobserved confounders in observational studies.

机译:适应观察研究中未观察到的混杂因素。

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摘要

Making valid inferences about effects attributable to a particular treatment condition on a health outcome of interest is an important goal in many epidemiological studies and is also a challenging topic for biostatistical research. Almost all the currently available biostatistical methodologies make the inference under the assumption that all the confounding variables between treatment and outcome are known, observed, and measured, excluding the possibility of unmeasured confounding variables. Although many investigators have recognized that the failure to take unmeasured confounding variables into account leads to substantially biased estimates of treatment effect, until now there lacks analytic techniques that properly addresses the challenge of unmeasured confounding variables in observational studies and randomized experimental studies with missing data.;A method of accounting for unmeasured confounding variables that we call latent variable analysis of unmeasured confounding variables (LVAUC) is developed in this dissertation. The LVAUC approach aims at estimating effects attributable to a treatment condition in the presence of unmeasured confounding variables. The method applies to general observational studies, including longitudinal studies with time-varying treatments. Moreover, this method is extended to deal with non-ignorable missing data. The estimator of treatment effect derived from the method is shown to be consistent and the performance of the method is tested with various simulations studies. The method is also illustrated with a data set from a health services research study entitled Access to Community Care and Effective Services and Supports (ACCESS) program and a longitudinal antipsychotic trial-Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia study.
机译:对特定治疗条件对目标健康结果的影响做出有效推论是许多流行病学研究的重要目标,也是生物统计学研究的具有挑战性的主题。几乎所有当前可用的生物统计学方法都是在已知,观察和测量的治疗和结果之间的所有混杂变量的假设下进行推断的,其中不包括无法测量的混杂变量的可能性。尽管许多研究人员已经认识到未能将无法测量的混杂变量考虑在内会导致治疗效果的估计偏差,但直到现在,仍缺乏分析技术来正确应对观察性研究和缺少数据的随机实验研究中无法测量的混杂变量的挑战。 ;本文提出了一种计算未测混杂变量的方法,我们称其为未测混杂变量的隐变量分析(LVAUC)。 LVAUC方法旨在在存在无法测量的混杂变量的情况下估计可归因于治疗条件的影响。该方法适用于一般观察研究,包括采用时变处理的纵向研究。此外,此方法已扩展为处理不可忽略的丢失数据。结果表明,从该方法得出的治疗效果估算值是一致的,并通过各种模拟研究测试了该方法的性能。该方法还通过一项名为“获得社区护理和有效服务与支持(ACCESS)计划”的卫生服务研究和一项纵向抗精神病药物-干预有效性临床抗精神病药物试验(CATIE)精神分裂症研究的数据集进行了说明。

著录项

  • 作者

    Tian, Yu.;

  • 作者单位

    Yale University.;

  • 授予单位 Yale University.;
  • 学科 Biology Biostatistics.
  • 学位 Ph.D.
  • 年度 2009
  • 页码 191 p.
  • 总页数 191
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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