Assessing treatment effects in observational data with missing confounders: A comparative study of practical doubly-robust and traditional missing data methods

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Main Authors: Williamson, Brian D., Krakauer, Chloe, Johnson, Eric, Gruber, Susan, Shepherd, Bryan E., van der Laan, Mark J., Lumley, Thomas, Lee, Hana, Munoz, Jose J. Hernandez, Zhao, Fengyu, Dutcher, Sarah K., Desai, Rishi, Simon, Gregory E., Shortreed, Susan M., Nelson, Jennifer C., Shaw, Pamela A.
Format: Preprint
Published: 2024
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author Williamson, Brian D.
Krakauer, Chloe
Johnson, Eric
Gruber, Susan
Shepherd, Bryan E.
van der Laan, Mark J.
Lumley, Thomas
Lee, Hana
Munoz, Jose J. Hernandez
Zhao, Fengyu
Dutcher, Sarah K.
Desai, Rishi
Simon, Gregory E.
Shortreed, Susan M.
Nelson, Jennifer C.
Shaw, Pamela A.
author_facet Williamson, Brian D.
Krakauer, Chloe
Johnson, Eric
Gruber, Susan
Shepherd, Bryan E.
van der Laan, Mark J.
Lumley, Thomas
Lee, Hana
Munoz, Jose J. Hernandez
Zhao, Fengyu
Dutcher, Sarah K.
Desai, Rishi
Simon, Gregory E.
Shortreed, Susan M.
Nelson, Jennifer C.
Shaw, Pamela A.
contents In pharmacoepidemiology, safety and effectiveness are frequently evaluated using readily available administrative and electronic health records data. In these settings, detailed confounder data are often not available in all data sources and therefore missing on a subset of individuals. Multiple imputation (MI) and inverse-probability weighting (IPW) are go-to analytical methods to handle missing data and are dominant in the biomedical literature. Doubly-robust methods, which are consistent under fewer assumptions, can be more efficient with respect to mean-squared error. We discuss two practical-to-implement doubly-robust estimators, generalized raking and inverse probability-weighted targeted maximum likelihood estimation (TMLE), which are both currently under-utilized in biomedical studies. We compare their performance to IPW and MI in a detailed numerical study for a variety of synthetic data-generating and missingness scenarios, including scenarios with rare outcomes and a high missingness proportion. Further, we consider plasmode simulation studies that emulate the complex data structure of a large electronic health records cohort in order to compare anti-depressant therapies in a rare-outcome setting where a key confounder is prone to more than 50\% missingness. We provide guidance on selecting a missing data analysis approach, based on which methods excelled with respect to the bias-variance trade-off across the different scenarios studied.
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id arxiv_https___arxiv_org_abs_2412_15012
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle Assessing treatment effects in observational data with missing confounders: A comparative study of practical doubly-robust and traditional missing data methods
Williamson, Brian D.
Krakauer, Chloe
Johnson, Eric
Gruber, Susan
Shepherd, Bryan E.
van der Laan, Mark J.
Lumley, Thomas
Lee, Hana
Munoz, Jose J. Hernandez
Zhao, Fengyu
Dutcher, Sarah K.
Desai, Rishi
Simon, Gregory E.
Shortreed, Susan M.
Nelson, Jennifer C.
Shaw, Pamela A.
Methodology
In pharmacoepidemiology, safety and effectiveness are frequently evaluated using readily available administrative and electronic health records data. In these settings, detailed confounder data are often not available in all data sources and therefore missing on a subset of individuals. Multiple imputation (MI) and inverse-probability weighting (IPW) are go-to analytical methods to handle missing data and are dominant in the biomedical literature. Doubly-robust methods, which are consistent under fewer assumptions, can be more efficient with respect to mean-squared error. We discuss two practical-to-implement doubly-robust estimators, generalized raking and inverse probability-weighted targeted maximum likelihood estimation (TMLE), which are both currently under-utilized in biomedical studies. We compare their performance to IPW and MI in a detailed numerical study for a variety of synthetic data-generating and missingness scenarios, including scenarios with rare outcomes and a high missingness proportion. Further, we consider plasmode simulation studies that emulate the complex data structure of a large electronic health records cohort in order to compare anti-depressant therapies in a rare-outcome setting where a key confounder is prone to more than 50\% missingness. We provide guidance on selecting a missing data analysis approach, based on which methods excelled with respect to the bias-variance trade-off across the different scenarios studied.
title Assessing treatment effects in observational data with missing confounders: A comparative study of practical doubly-robust and traditional missing data methods
topic Methodology
url https://arxiv.org/abs/2412.15012