arXiv subjects

Lan Wen

Publications and source records attributed to Lan Wen.

14 recordsLinked to original sources

arXiv2026

Doubly robust Methods for Recurrent Event Outcomes: Causal Effects of Blood Pressure Medications on Acute Kidney Injuries

Evaluating the average causal effects of treatment strategies on recurrent event outcomes, such as heart attacks or renal failure, is important in clinical and medical research. However, the analysis becomes increasingly complex as multiple interacting factors are considered within a longitudinal setting. In this paper, we use advanced methodologies to estimate the average causal effects of standard versus intensive blood pressure-lowering therapies on acute kidney injury recurrences. We address time-varying treatment and confounding, and model misspecification during the identification and estimation processes for the effect estimands. We analyze the Systolic Blood Pressure Intervention Trial data set using our proposed method, accounting for medication adherence and the semi-competing risk of death observed in the data.

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arXiv2026

Generalizing conditional average treatment effects from nested randomized trials to all trial-eligible individuals

Randomized controlled trials often enroll participants whose characteristics differ from those of a target population, which can limit the generalizability of the estimated treatment effects when effect modifiers differ across populations. While existing generalizability methods primarily focus on estimating the average treatment effect (ATE) in the target population, such summaries may obscure important heterogeneity that is relevant for clinical and policy decision-making. In this work, we illustrate an approach for estimating the conditional average treatment effect (CATE) in a target population of trial-eligible individuals as a function of prespecified effect modifiers within a nested trial setting. Our approach combines semiparametric theory with flexible estimation: we first estimate nuisance functions using data-adaptive methods and construct pseudo-outcomes from conditional influence functions, then estimate the CATE function via local linear (kernel) regression. Sample splitting and cross-fitting are used to reduce overfitting bias and ensure asymptotic valid inference. Finite-sample performance is assessed via simulations and illustrated in the Coronary Artery Surgery Study (CASS).

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arXiv2025

On treating right-censoring events like treatments

In causal inference literature, potential outcomes are often indexed by the "elimination of all right-censoring events," leading to the perception that such a restriction is necessary for defining well-posed causal estimands. In this paper, we clarify that this restriction is not required: a well-defined estimand can be formulated without indexing on the elimination of such events. Achieving this requires a more precise classification of right-censoring events than has historically been considered, as the nature of these events has direct implications for identification of the target estimand. We provide a framework that distinguishes different types of right-censoring events from a causal perspective, and demonstrate how this framework relates to censoring definitions and assumptions in classical survival analysis literature. By bridging these perspectives, we provide a clearer understanding of how to handle right-censoring events and provide guidance for identifying causal estimands when right-censored events are present.

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arXiv2025

Estimating average treatment effects when treatment data are absent in a target study

Researchers are frequently interested in understanding the causal effect of treatment interventions. However, in some cases, the treatment of interest--readily available in a randomized controlled trial (RCT)--is either not directly measured or entirely unavailable in observational datasets. This challenge has motivated the development of stochastic incremental propensity score interventions which operate on post-treatment exposures affected by the treatment of interest with the aim of approximating the causal effects of the treatment intervention. Yet, a key challenge lies in the fact that the precise distributional shift of these post-treatment exposures induced by the treatment is typically unknown, making it uncertain whether the approximation truly reflects the causal effect of interest. The primary objective of this paper is to explore data integration methodologies to characterize a distribution of post-treatment exposures resulting from the treatment in an external dataset, and to use this information to estimate counterfactual mean outcomes under treatment interventions, in settings where the observational data lack treatment information and the external data may not contain measurements of the outcome of interest. We will discuss the underlying assumptions required for this approach and provide methodological guidance on estimation strategies to address these challenges.

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arXiv2025

Estimating Average Causal Effects with Incomplete Exposure and Confounders

Standard methods for estimating average causal effects require complete observations of the exposure and confounders. In observational studies, however, missing data are ubiquitous. Motivated by a study on the effect of prescription opioids on mortality, we propose methods for estimating average causal effects when exposures and potential confounders may be missing. We consider missingness at random and additionally propose several specific missing not at random (MNAR) assumptions. Under our proposed MNAR assumptions, we show that the average causal effects are identified from the observed data and derive corresponding influence functions in a nonparametric model, which form the basis of our proposed estimators. Our simulations show that standard multiple imputation techniques paired with a complete data estimator is unbiased when data are missing at random (MAR) but can be biased otherwise. For each of the MNAR assumptions, we instead propose doubly robust targeted maximum likelihood estimators (TMLE), allowing misspecification of either (i) the outcome models or (ii) the exposure and missingness models. The proposed methods are suitable for any outcome types, and we apply them to a motivating study that examines the effect of prescription opioid usage on all-cause mortality using data from the National Health and Nutrition Examination Survey (NHANES).

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arXiv2024

Interpretable meta-analysis of model or marker performance

Conventional meta analysis of model performance conducted using datasources from different underlying populations often result in estimates that cannot be interpreted in the context of a well defined target population. In this manuscript we develop methods for meta-analysis of several measures of model performance that are interpretable in the context of a well defined target population when the populations underlying the datasources used in the meta analysis are heterogeneous. This includes developing identifiablity conditions, inverse-weighting, outcome model, and doubly robust estimator. We illustrate the methods using simulations and data from two large lung cancer screening trials.

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arXiv2024

Grace periods in comparative effectiveness studies of sustained treatments

Researchers are often interested in estimating the effect of sustained use of a treatment on a health outcome. However, adherence to strict treatment protocols can be challenging for individuals in practice and, when non-adherence is expected, estimates of the effect of sustained use may not be useful for decision making. As an alternative, more relaxed treatment protocols which allow for periods of time off treatment (i.e. grace periods) have been considered in pragmatic randomized trials and observational studies. In this article, we consider the interpretation, identification, and estimation of treatment strategies which include grace periods. We contrast natural grace period strategies which allow individuals the flexibility to take treatment as they would naturally do, with stochastic grace period strategies in which the investigator specifies the distribution of treatment utilization. We estimate the effect of initiation of a thiazide diuretic or an angiotensin-converting enzyme inhibitor in hypertensive individuals under various strategies which include grace periods.

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arXiv2023

Causal effects of intervening variables in settings with unmeasured confounding

We present new results on average causal effects in settings with unmeasured exposure-outcome confounding. Our results are motivated by a class of estimands, e.g., frequently of interest in medicine and public health, that are currently not targeted by standard approaches for average causal effects. We recognize these estimands as queries about the average causal effect of an intervening variable. We anchor our introduction of these estimands in an investigation of the role of chronic pain and opioid prescription patterns in the opioid epidemic, and illustrate how conventional approaches will lead unreplicable estimates with ambiguous policy implications. We argue that our altenative effects are replicable and have clear policy implications, and furthermore are non-parametrically identified by the classical frontdoor formula. As an independent contribution, we derive a new semiparametric efficient estimator of the frontdoor formula with a uniform sample boundedness guarantee. This property is unique among previously-described estimators in its class, and we demonstrate superior performance in finite-sample settings. Theoretical results are applied with data from the National Health and Nutrition Examination Survey.

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arXiv2023

Interpretational errors in statistical causal inference

We formalize an interpretational error that is common in statistical causal inference, termed identity slippage. This formalism is used to describe historically-recognized fallacies, and analyse a fast-growing literature in statistics and applied fields. We conducted a systematic review of natural language claims in the literature on stochastic mediation parameters, and documented extensive evidence of identity slippage in applications. This framework for error detection is applicable whenever policy decisions depend on the accurate interpretation of statistical results, which is nearly always the case. Therefore, broad awareness of identity slippage will aid statisticians in the successful translation of data into public good.

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arXiv2022

Intervention treatment distributions that depend on the observed treatment process and model double robustness in causal survival analysis

The generalized g-formula can be used to estimate the probability of survival under a sustained treatment strategy. When treatment strategies are deterministic, estimators derived from the so-called efficient influence function (EIF) for the g-formula will be doubly robust to model misspecification. In recent years, several practical applications have motivated estimation of the g-formula under non-deterministic treatment strategies where treatment assignment at each time point depends on the observed treatment process. In this case, EIF-based estimators may or may not be doubly robust. In this paper, we provide sufficient conditions to ensure existence of doubly robust estimators for intervention treatment distributions that depend on the observed treatment process for point treatment interventions, and give a class of intervention treatment distributions dependent on the observed treatment process that guarantee model doubly and multiply robust estimators in longitudinal settings. Motivated by an application to pre-exposure prophylaxis (PrEP) initiation studies, we propose a new treatment intervention dependent on the observed treatment process. We show there exist 1) estimators that are doubly and multiply robust to model misspecification, and 2) estimators that when used with machine learning algorithms can attain fast convergence rates for our proposed intervention. Theoretical results are confirmed via simulation studies.

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arXiv2020

No-shadowing for singular hyperbolic sets with a singularity

We prove that every singular hyperbolic chain transitive set with a singularity does not admit the shadowing property. Using this result we show that if a star flow has the shadowing property on its chain recurrent set then it satisfies Axiom A and the no-cycle conditions; and that if a multisingular hyperbolic set has the shadowing property then it is hyperbolic.

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arXiv2017

A rescaled expansiveness for flows

We introduce a new version of expansiveness for flows. Let $M$ be a compact Riemannian manifold without boundary and $X$ be a $C^1$ vector field on $M$ that generates a flow $φ_t$ on $M$. We call $X$ {\it rescaling expansive} on a compact invariant set $Λ$ of $X$ if for any $ε>0$ there is $δ>0$ such that, for any $x,y\in Λ$ and any time reparametrization $θ:\mathbb{R}\to \mathbb{R}$, if $d(φ_t(x), φ_{θ(t)}(y)\le δ\|X(φ_t(x))\|$ for all $t\in \mathbb R$, then $φ_{θ(t)}(y)\in φ_{[-ε, ε]}(φ_t(x))$ for all $t\in \mathbb R$. We prove that every multisingular hyperbolic set (singular hyperbolic set in particular) is rescaling expansive and a converse holds generically.

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arXiv2014

Codimension one structurally stable chain classes

The well known stability conjecture of Palis and Smale states that if a diffeomorphism is structurally stable then the chain recurrent set is hyperbolic. It is natural to ask if this type of results is true for an individual chain class, that is, whether or not every structurally stable chain class is hyperbolic. Regarding the notion of structural stability, there is a subtle difference between the case of a whole system and the case of an individual chain class. The later case is more delicate and contains additional difficulties. In this paper we prove a result of this type for the later case, with an additional assumption of codimension 1. Precisely, let $f$ be a diffeomorphism of a closed manifold $M$ and $p$ be a hyperbolic periodic point of $f$ of index 1 or $\dim M-1$. We prove if the chain class of $p$ is structurally stable then it is hyperbolic. Since the chain class of $p$ is not assumed in advance to be locally maximal, and since the counterpart of it for the perturbation $g$ is defined not canonically but indirectly through the continuation $p_g$ of $p$, the proof is quite delicate.

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arXiv2014

On the singular hyperbolicity of star flows

We prove for a generic star vector field $X$ that, if for every chain recurrent class $C$ of $X$ all singularities in $C$ have the same index, then the chain recurrent set of $X$ is singular hyperbolic. We also prove that every Lyapunov stable chain recurrent class of $X$ is singular hyperbolic. As a corollary, we prove that the chain recurrent set of a generic 4-dimensional star flow is singular hyperbolic.

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