Elucidating some common biases in randomized controlled trials using directed acyclic graphs.

IF 5.9 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Erin E Gabriel,Alex Ocampo,Arvid Sjölander
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引用次数: 0

Abstract

Although the ideal randomized clinical trial is the gold standard for causal inference, real randomized trials often suffer from imperfections that may hamper causal effect estimation. Stating the estimand of interest can help reduce confusion about what is being estimated, but it is often difficult to determine what is and is not identifiable given a trial's specific imperfections. We demonstrate how directed acyclic graphs can be used to elucidate the consequences of common imperfections, such as noncompliance, unblinding, and drop-out, for the identification of the intention-to-treat effect, the total treatment effect and the physiological treatment effect. We assert that the physiological treatment effect is not identifiable outside a trial with perfect compliance and no dropout, where blinding is perfectly maintained.
用有向无环图阐明随机对照试验中的一些常见偏差。
虽然理想的随机临床试验是因果推理的黄金标准,但真正的随机试验往往存在可能妨碍因果效应估计的不完善之处。陈述感兴趣的估计可以帮助减少对正在估计的东西的混淆,但是通常很难确定什么是可识别的,什么是不可识别的,因为试验有特定的缺陷。我们展示了如何使用有向无环图来阐明常见缺陷的后果,例如不依从性、解盲和退出,以确定意向治疗效果、总治疗效果和生理治疗效果。我们断言,生理治疗效果是无法识别的试验之外,完全依从性和无退出,其中盲法是完全维持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
European Journal of Epidemiology
European Journal of Epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
21.40
自引率
1.50%
发文量
109
审稿时长
6-12 weeks
期刊介绍: The European Journal of Epidemiology, established in 1985, is a peer-reviewed publication that provides a platform for discussions on epidemiology in its broadest sense. It covers various aspects of epidemiologic research and statistical methods. The journal facilitates communication between researchers, educators, and practitioners in epidemiology, including those in clinical and community medicine. Contributions from diverse fields such as public health, preventive medicine, clinical medicine, health economics, and computational biology and data science, in relation to health and disease, are encouraged. While accepting submissions from all over the world, the journal particularly emphasizes European topics relevant to epidemiology. The published articles consist of empirical research findings, developments in methodology, and opinion pieces.
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