Causal inference with multiple concurrent medications: A comparison of methods and an application in multidrug-resistant tuberculosis

Details

• Alternative Title:
  Stat Methods Med Res
• Personal Author:
  Siddique, Arman Alam ; Schnitzer, Mireille E ; Bahamyirou, Asma ; Wang, Guanbo ; Holtz, Timothy H ; Migliori, Giovanni B ; Sotgiu, Giovanni ; Gandhi, Neel R ; Vargas, Mario H ; Menzies, Dick ; Benedetti, Andrea
• Description:
  This paper investigates different approaches for causal estimation under multiple concurrent medications. Our parameter of interest is the marginal mean counterfactual outcome under different combinations of medications. We explore parametric and non-parametric methods to estimate the generalized propensity score. We then apply three causal estimation approaches (inverse probability of treatment weighting, propensity score adjustment, and targeted maximum likelihood estimation) to estimate the causal parameter of interest. Focusing on the estimation of the expected outcome under the most prevalent regimens, we compare the results obtained using these methods in a simulation study with four potentially concurrent medications. We perform a second simulation study in which some combinations of medications may occur rarely or not occur at all in the dataset. Finally, we apply the methods explored to contrast the probability of patient treatment success for the most prevalent regimens of antimicrobial agents for patients with multidrug-resistant pulmonary tuberculosis.
• Subjects:
  Causality Drug-Related Side Effects And Adverse Reactions Humans Likelihood Functions Machine Learning Models, Statistical Polypharmacology Propensity Score Regression Analysis Treatment Outcome Tuberculosis, Multidrug-Resistant

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• Keywords:
  Causal Inference Chlorination Concurrent Medications Generalized Propensity Score Household Water Treatment Machine Learning Multidrug-resistant Tuberculosis Safe Water Storage Targeted Maximum Likelihood Estimation
• Source:
  Stat Methods Med Res. 28(12):3534-3549
• Pubmed ID:
  30381005
• Pubmed Central ID:
  PMC6511477
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; K24 AI114444/AI/NIAID NIH HHSUnited States/ ; 378067/CIHRCanada/ ; U19 AI111211/AI/NIAID NIH HHSUnited States/ ; P30 AI050409/AI/NIAID NIH HHSUnited States/
• Volume:
  28
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:779030965e0b77d30ec9c3f56ab593d9763847087d2d89bafe93b09d7120cd66
• Download URL:
  https://stacks.cdc.gov/view/cdc/78410/cdc_78410_DS1.pdf
• File Type:
  [PDF - 432.40 KB ]