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Yunji Zhou

Publications and source records attributed to Yunji Zhou.

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Variance Estimation for Weighted Average Treatment Effects

Common variance estimation methods for weighted average treatment effects (WATEs) in observational studies include nonparametric bootstrap and model-based, closed-form sandwich variance estimation. However, the computational cost of bootstrap increases with the size of the data at hand. Besides, some replicates may exhibit random violations of the positivity assumption even when the original data do not. Sandwich variance estimation relies on regularity conditions that may be structurally violated. Moreover, the sandwich variance estimation is model-dependent on the propensity score model, the outcome model, or both; thus it does not have a unified closed-form expression. Recent studies have explored the use of wild bootstrap to estimate the variance of the average treatment effect on the treated (ATT). This technique adopts a one-dimensional, nonparametric, and computationally efficient resampling strategy. In this article, we propose a "post-weighting" bootstrap approach as an alternative to the conventional bootstrap, which helps avoid random positivity violations in replicates and improves computational efficiency. We also generalize the wild bootstrap algorithm from ATT to the broader class of WATEs by providing new justification for correctly accounting for sampling variability from multiple sources under different weighting functions. We evaluate the performance of all four methods through extensive simulation studies and demonstrate their application using data from the National Health and Nutrition Examination Survey (NHANES). Our findings offer several practical recommendations for the variance estimation of WATE estimators.

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Average treatment effect on the treated, under lack of positivity

The use of propensity score (PS) methods has become ubiquitous in causal inference. At the heart of these methods is the positivity assumption. Violation of the positivity assumption leads to the presence of extreme PS weights when estimating average causal effects of interest, such as the average treatment effect (ATE) or the average treatment effect on the treated (ATT), which renders invalid related statistical inference. To circumvent this issue, trimming or truncating the extreme estimated PSs have been widely used. However, these methods require that we specify a priori a threshold and sometimes an additional smoothing parameter. While there are a number of methods dealing with the lack of positivity when estimating ATE, surprisingly there is no much effort in the same issue for ATT. In this paper, we first review widely used methods, such as trimming and truncation in ATT. We emphasize the underlying intuition behind these methods to better understand their applications and highlight their main limitations. Then, we argue that the current methods simply target estimands that are scaled ATT (and thus move the goalpost to a different target of interest), where we specify the scale and the target populations. We further propose a PS weight-based alternative for the average causal effect on the treated, called overlap weighted average treatment effect on the treated (OWATT). The appeal of our proposed method lies in its ability to obtain similar or even better results than trimming and truncation while relaxing the constraint to choose a priori a threshold (or even specify a smoothing parameter). The performance of the proposed method is illustrated via a series of Monte Carlo simulations and a data analysis on racial disparities in health care expenditures.

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Overlap, matching, or entropy weights: what are we weighting for?

There has been a recent surge in statistical methods for handling the lack of adequate positivity when using inverse probability weights (IPW). However, these nascent developments have raised a number of questions. Thus, we demonstrate the ability of equipoise estimators (overlap, matching, and entropy weights) to handle the lack of positivity. Compared to IPW, the equipoise estimators have been shown to be flexible and easy to interpret. However, promoting their wide use requires that researchers know clearly why, when to apply them and what to expect. In this paper, we provide the rationale to use these estimators to achieve robust results. We specifically look into the impact imbalances in treatment allocation can have on the positivity and, ultimately, on the estimates of the treatment effect. We zero into the typical pitfalls of the IPW estimator and its relationship with the estimators of the average treatment effect on the treated (ATT) and on the controls (ATC). Furthermore, we also compare IPW trimming to the equipoise estimators. We focus particularly on two key points: What fundamentally distinguishes their estimands? When should we expect similar results? Our findings are illustrated through Monte-Carlo simulation studies and a data example on healthcare expenditure.

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Variance estimation for the average treatment effects on the treated and on the controls

Common causal estimands include the average treatment effect (ATE), the average treatment effect of the treated (ATT), and the average treatment effect on the controls (ATC). Using augmented inverse probability weighting methods, parametric models are judiciously leveraged to yield doubly robust estimators, i.e., estimators that are consistent when at least one the parametric models is correctly specified. Three sources of uncertainty are associated when we evaluate these estimators and their variances, i.e., when we estimate the treatment and outcome regression models as well as the desired treatment effect. In this paper, we propose methods to calculate the variance of the normalized, doubly robust ATT and ATC estimators and investigate their finite sample properties. We consider both the asymptotic sandwich variance estimation, the standard bootstrap as well as two wild bootstrap methods. For the asymptotic approximations, we incorporate the aforementioned uncertainties via estimating equations. Moreover, unlike the standard bootstrap procedures, the proposed wild bootstrap methods use perturbations of the influence functions of the estimators through independently distributed random variables. We conduct an extensive simulation study where we vary the heterogeneity of the treatment effect as well as the proportion of participants assigned to the active treatment group. We illustrate the methods using an observational study of critical ill patients on the use of right heart catherization.

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Constrained randomization and statistical inference for multi-arm parallel cluster randomized controlled trials

A practical limitation of cluster randomized controlled trials (cRCTs) is that the number of available clusters may be small, resulting in an increased risk of baseline imbalance under simple randomization. Constrained randomization overcomes this issue by restricting the allocation to a subset of randomization schemes where sufficient overall covariate balance across comparison arms is achieved. However, for multi-arm cRCTs, several design and analysis issues pertaining to constrained randomization have not been fully investigated. Motivated by an ongoing multi-arm cRCT, we elaborate the method of constrained randomization and provide a comprehensive evaluation of the statistical properties of model-based and randomization-based tests under both simple and constrained randomization designs in multi-arm cRCTs, with varying combinations of design and analysis-based covariate adjustment strategies. In particular, as randomization-based tests have not been extensively studied in multi-arm cRCTs, we additionally develop most-powerful randomization tests under the linear mixed model framework for our comparisons. Our results indicate that under constrained randomization, both model-based and randomization-based analyses could gain power while preserving nominal type I error rate, given proper analysis-based adjustment for the baseline covariates. Randomization-based analyses, however, are more robust against violations of distributional assumptions. The choice of balance metrics and candidate set sizes and their implications on the testing of the pairwise and global hypotheses are also discussed. Finally, we caution against the design and analysis of multi-arm cRCTs with an extremely small number of clusters, due to insufficient degrees of freedom and the tendency to obtain an overly restricted randomization space.

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A framework for causal inference in the presence of extreme inverse probability weights: the role of overlap weights

In this paper, we consider recent progress in estimating the average treatment effect when extreme inverse probability weights are present and focus on methods that account for a possible violation of the positivity assumption. These methods aim at estimating the treatment effect on the subpopulation of patients for whom there is a clinical equipoise. We propose a systematic approach to determine their related causal estimands and develop new insights into the properties of the weights targeting such a subpopulation. Then, we examine the roles of overlap weights, matching weights, Shannon's entropy weights, and beta weights. This helps us characterize and compare their underlying estimators, analytically and via simulations, in terms of the accuracy, precision, and root mean squared error. Moreover, we study the asymptotic behaviors of their augmented estimators (that mimic doubly robust estimators), which lead to improved estimations when either the propensity or the regression models are correctly specified. Based on the analytical and simulation results, we conclude that overall overlap weights are preferable to matching weights, especially when there is moderate or extreme violations of the positivity assumption. Finally, we illustrate the methods using a real data example marked by extreme inverse probability weights.

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Propensity score weighting under limited overlap and model misspecification

Propensity score (PS) weighting methods are often used in non-randomized studies to adjust for confounding and assess treatment effects. The most popular among them, the inverse probability weighting (IPW), assigns weights that are proportional to the inverse of the conditional probability of a specific treatment assignment, given observed covariates. A key requirement for IPW estimation is the positivity assumption, i.e., the PS must be bounded away from 0 and 1. In practice, violations of the positivity assumption often manifest by the presence of limited overlap in the PS distributions between treatment groups. When these practical violations occur, a small number of highly influential IPW weights may lead to unstable IPW estimators, with biased estimates and large variances. To mitigate these issues, a number of alternative methods have been proposed, including IPW trimming, overlap weights (OW), matching weights (MW), and entropy weights (EW). Because OW, MW, and EW target the population for whom there is equipoise (and with adequate overlap) and their estimands depend on the true PS, a common criticism is that these estimators may be more sensitive to misspecifications of the PS model. In this paper, we conduct extensive simulation studies to compare the performances of IPW and IPW trimming against those of OW, MW, and EW under limited overlap and misspecified propensity score models. Across the wide range of scenarios we considered, OW, MW, and EW consistently outperform IPW in terms of bias, root mean squared error, and coverage probability.

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