title: Causal effect estimation strategies in a longitudinal study with complex time-varying confounders: A tutorial.
abstract: The Dutch Sciatica Trial represents a longitudinal study with complex time-varying confounders as patients with poorer health conditions (e.g. more severe pain) are more likely to opt for surgery, which, in turn, may affect future outcomes (pain severity). A straightforward classical as-treated comparison at the end point would lead to biased estimation of the surgery effect. We present several strategies of causal treatment effect estimation that might be applicable for analyzing such data. These include an inverse probability of treatment weighted regression analysis, a marginal weighted analysis, an unweighted regression analysis, and several propensity score-based approaches. In addition, we demonstrate how to evaluate these approaches in a thorough simulation study where we generate various realistic complex confounding patterns akin to the sciatica study.
authors.affiliation: 1 Department of Medical Statistics, Leiden University Medical Center, RC Leiden, The Netherlands.
authors.forename: Bart Ja
authors.initials: BJ
authors.lastname: Mertens
authors.affiliation: 3 Department of Neurosurgery, Leiden University Medical Center, RC Leiden, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Datta
authors.affiliation: 1 Department of Medical Statistics, Leiden University Medical Center, RC Leiden, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Brand
authors.affiliation: 2 Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY 40292, USA.
authors.forename: W
authors.initials: W
authors.lastname: Peul
mesh_terms: D003198:Computer Simulation; D015986:Confounding Factors, Epidemiologic; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D009426:Netherlands; D010146:Pain / Q000209:etiology; D057216:Propensity Score; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012044:Regression Analysis; D012585:Sciatica / Q000150:complications / Q000601:surgery
keywords: causal; inverse probability weighting; propensity; sciatica