Methods for Extending Inferences From Observational Studies: Considering Causal Structures, Identification Assumptions, and Estimators.

Autor:	Hayes-Larson E; From the Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA., Zhou Y; From the Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA.; Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA., Rojas-Saunero LP; From the Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA., Shaw C; Amgen Inc., Thousand Oaks, CA., Seamans MJ; From the Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA., Glymour MM; Department of Epidemiology, Boston University School of Public Health, Boston, MA., Murchland AR; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA., Westreich D; Department of Epidemiology, UNC Gillings School of Public Health, Chapel Hill, NC., Mayeda ER; From the Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA.
Jazyk:	angličtina
Zdroj:	Epidemiology (Cambridge, Mass.) [Epidemiology] 2024 Nov 01; Vol. 35 (6), pp. 753-763. Date of Electronic Publication: 2024 Aug 09.
DOI:	10.1097/EDE.0000000000001780
Abstrakt:	Most prior work in quantitative approaches to generalizability and transportability emphasizes extending causal effect estimates from randomized trials to target populations. Extending findings from observational studies is also of scientific interest, and identifiability assumptions and estimation methods differ from randomized settings when there is selection on both the exposure and exposure-outcome mediators in combination with exposure-outcome confounders (and both confounders and mediators can modify exposure-outcome effects). We argue that this causal structure is common in observational studies, particularly in the field of life course epidemiology, for example, when extending estimates of the effect of an early-life exposure on a later-life outcome from a cohort enrolled in midlife or late life. We describe identifiability assumptions and identification using observed data in such settings, highlighting differences from work extending findings from randomized trials. We describe statistical methods, including weighting, outcome modeling, and doubly robust approaches, to estimate potential outcome means and average treatment effects in the target population and illustrate performance of the methods in a simulation study. We show that in the presence of selection into the study sample on both exposure and confounders, estimators must be able to address confounding in the target population. When there is also selection on mediators of the exposure-outcome relationship, estimators need to be able to use different sets of variables to account for selection (including the mediator), and confounding. We discuss conceptual implications of our results as well as highlight unresolved practical questions for applied work to extend findings from observational studies to target populations. Competing Interests: Disclosure: The authors report no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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