Analysis of stepped wedge cluster randomized trials in the presence of a time-varying treatment effect
处理效应随暴露时间变化时的阶梯楔形整群随机试验分析AI 解读 ↓
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处理效应随暴露时间变化时的阶梯楔形整群随机试验分析AI 解读 ↓
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Stepped wedge cluster randomized controlled trials are typically analyzed using models that assume the full effect of the treatment is achieved instantaneously. We provide an analytical framework for scenarios in which the treatment effect varies as a function of exposure time (time since the start of treatment) and define the "effect curve" as the magnitude of the treatment effect on the linear predictor scale as a function of exposure time. The "time-averaged treatment effect", (TATE) and "long-term treatment effect" (LTE) are summaries of this curve. We analytically derive the expectation of the estimator resulting from a model that assumes an immediate treatment effect and show that it can be expressed as a weighted sum of the time-specific treatment effects corresponding to the observed exposure times. Surprisingly, although the weights sum to one, some of the weights can be negative. This implies that the estimator may be severely misleading and can even converge to a value of the opposite sign of the true TATE or LTE. We describe several models that can be used to simultaneously estimate the entire effect curve, the TATE, and the LTE, some of which make assumptions about the shape of the effect curve. We evaluate these models in a simulation study to examine the operating characteristics of the resulting estimators and apply them to two real datasets.
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含时变中介变量与滞后结果的双重差分模型
We study difference-in-differences (DiD) designs in which a binary treatment changes an endogenous time-varying (continuous, discrete, or mixed) mediator that in turn affects an outcome. We allow for the inclusion of lagged outcomes in the model. Under our model assumptions, we show that the usual DiD estimand mixes the average direct effect on the treated, the average indirect effect, and a trend bias term. A two-way fixed effects (TWFE) regression that controls for the…