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Yu-Han Chiu

Publications and source records attributed to Yu-Han Chiu.

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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).

stat.ME

The role of assignment in defining and identifying causal effects in randomized trials

In randomized trials, the per-protocol effect, that is, the effect of being assigned a treatment strategy and receiving treatment according to the assigned strategy, is sometimes thought to reflect the effect of the treatment strategy itself, without intervention on assignment. Here, we argue by example that this is not necessarily the case. We examine a causal structure for a randomized trial where these two causal estimands -- the per-protocol effect and the effect of the treatment strategy -- are not equal, and where their corresponding identifying observed data functionals are not the same, but both require information on assignment for identification. Our example highlights the conceptual difference between the per-protocol effect and the effect of the treatment strategy, the conditions under which these causal estimands are equal, and suggests that in some cases their identification requires information on assignment, even when assignment is randomized. Furthermore, both per-protocol effects and effects of treatment may be unidentifiable without information on treatment assignment, unless one makes additional assumptions -- informally, that assignment does not affect the outcome except through treatment (i.e., an exclusion-restriction assumption), and that assignment is not a confounder of the treatment-outcome association conditional on other variables in the analysis. Our analyses suggest a need to more clearly define the role of assignment when specifying causal effects of interest in randomized trials, which has implications for identification, analysis methods, and the interpretation of trial results.

stat.ME

Selection on treatment in the target population of generalizabillity and transportability analyses

Investigators are increasingly using novel methods for extending (generalizing or transporting) causal inferences from a trial to a target population. In many generalizability and transportability analyses, the trial and the observational data from the target population are separately sampled, following a non-nested trial design. In practical implementations of this design, non-randomized individuals from the target population are often identified by conditioning on the use of a particular treatment, while individuals who used other candidate treatments for the same indication or individuals who did not use any treatment are excluded. In this paper, we argue that conditioning on treatment in the target population changes the estimand of generalizability and transportability analyses and potentially introduces serious bias in the estimation of causal estimands in the target population or the subset of the target population using a specific treatment. Furthermore, we argue that the naive application of marginalization-based or weighting-based standardization methods does not produce estimates of any reasonable causal estimand. We use causal graphs and counterfactual arguments to characterize the identification problems induced by conditioning on treatment in the target population and illustrate the problems using simulated data. We conclude by considering the implications of our findings for applied work.

stat.ME