arXiv subjects

Rosanna Smart

Publications and source records attributed to Rosanna Smart.

4 recordsLinked to original sources

arXiv2024

Autoregressive models for panel data causal inference with application to state-level opioid policies

Motivated by the study of state opioid policies, we propose a novel approach that uses autoregressive models for causal effect estimation in settings with panel data and staggered treatment adoption. Specifically, we seek to estimate the impact of key opioid-related policies by quantifying the effects of must access prescription drug monitoring programs (PDMPs), naloxone access laws (NALs), and medical marijuana laws on opioid prescribing. Existing methods, such as differences-in-differences and synthetic controls, are challenging to apply in these types of dynamic policy landscapes where multiple policies are implemented over time and sample sizes are small. Autoregressive models are an alternative strategy that have been used to estimate policy effects in similar settings, but until this paper have lacked formal justification. We outline a set of assumptions that tie these models to causal effects, and we study biases of estimates based on this approach when key causal assumptions are violated. In a set of simulation studies that mirror the structure of our application, we show that our proposed estimators frequently outperform existing estimators. In short, we justify the use of autoregressive models to evaluate the effectiveness of four state policies in combating the opioid crisis.

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arXiv2022

Methodological considerations for estimating policy effects in the context of co-occurring policies

Understanding how best to estimate state-level policy effects is important, and several unanswered questions remain, particularly about the ability of statistical models to disentangle the effects of concurrently enacted policies. In practice, many policy evaluation studies do not attempt to control for effects of co-occurring policies, and this issue has not received extensive attention in the methodological literature to date. In this study, we utilized Monte Carlo simulations to assess the impact of co-occurring policies on the performance of commonly-used statistical models in state policy evaluations. Simulation conditions varied effect sizes of the co-occurring policies and length of time between policy enactment dates, among other factors. Outcome data (annual state-specific opioid mortality rate per 100,000) were obtained from 1999-2016 National Vital Statistics System (NVSS) Multiple Cause of Death mortality files, thus yielding longitudinal annual state-level data over 18 years from 50 states. When co-occurring policies are ignored (i.e., omitted from the analytic model), our results demonstrated that high relative bias (>85%) arises, particularly when policies are enacted in rapid succession. Moreover, as expected, controlling for all co-occurring policies will effectively mitigate the threat of confounding bias; however, effect estimates may be relatively imprecise (i.e., larger variance) when policies are enacted in near succession. Our findings highlight several key methodological issues regarding co-occurring policies in the context of opioid-policy research yet also generalize more broadly to evaluation of other state-level policies, such as policies related to firearms or COVID-19, showcasing the need to think critically about co-occurring policies that are likely to influence the outcome when specifying analytic models.

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arXiv2021

Estimating effects within nonlinear autoregressive models: a case study on the impact of child access prevention laws on firearm mortality

Autoregressive models are widely used for the analysis of time-series data, but they remain underutilized when estimating effects of interventions. This is in part due to endogeneity of the lagged outcome with any intervention of interest, which creates difficulty interpreting model coefficients. These problems are only exacerbated in nonlinear or nonadditive models that are common when studying crime, mortality, or disease. In this paper, we explore the use of negative binomial autoregressive models when estimating the effects of interventions on count data. We derive a simple approximation that facilitates direct interpretation of model parameters under any order autoregressive model. We illustrate the approach using an empirical simulation study using 36 years of state-level firearm mortality data from the United States and use the approach to estimate the effect of child access prevention laws on firearm mortality.

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arXiv2021

Moving beyond the classic difference-in-differences model: A simulation study comparing statistical methods for estimating effectiveness of state-level policies

State-level policy evaluations commonly employ a difference-in-differences (DID) study design; yet within this framework, statistical model specification varies notably across studies. Motivated by applied state-level opioid policy evaluations, this simulation study compares statistical performance of multiple variations of two-way fixed effect models traditionally used for DID under a range of simulation conditions. While most linear models resulted in minimal bias, non-linear models and population-weighted versions of classic linear two-way fixed effect and linear GEE models yielded considerable bias (60 to 160%). Further, root mean square error is minimized by linear AR models when examining crude mortality rates and by negative binomial models when examining raw death counts. In the context of frequentist hypothesis testing, many models yielded high Type I error rates and very low rates of correctly rejecting the null hypothesis (< 10%), raising concerns of spurious conclusions about policy effectiveness. When considering performance across models, the linear autoregressive models were optimal in terms of directional bias, root mean squared error, Type I error, and correct rejection rates. These findings highlight notable limitations of traditional statistical models commonly used for DID designs, designs widely used in opioid policy studies and in state policy evaluations more broadly.

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