Estimation of causal effects using instrumental variables with nonignorable missing covariates: application to effect of type of delivery NICU on premature infants
From MaRDI portal
Publication:2453655
Abstract: Understanding how effective high-level NICUs (neonatal intensive care units that have the capacity for sustained mechanical assisted ventilation and high volume) are compared to low-level NICUs is important and valuable for both individual mothers and for public policy decisions. The goal of this paper is to estimate the effect on mortality of premature babies being delivered in a high-level NICU vs. a low-level NICU through an observational study where there are unmeasured confounders as well as nonignorable missing covariates. We consider the use of excess travel time as an instrumental variable (IV) to control for unmeasured confounders. In order for an IV to be valid, we must condition on confounders of the IV---outcome relationship, for example, month prenatal care started must be conditioned on for excess travel time to be a valid IV. However, sometimes month prenatal care started is missing, and the missingness may be nonignorable because it is related to the not fully measured mother's/infant's risk of complications. We develop a method to estimate the causal effect of a treatment using an IV when there are nonignorable missing covariates as in our data, where we allow the missingness to depend on the fully observed outcome as well as the partially observed compliance class, which is a proxy for the unmeasured risk of complications. A simulation study shows that under our nonignorable missingness assumption, the commonly used estimation methods, complete-case analysis and multiple imputation by chained equations assuming missingness at random, provide biased estimates, while our method provides approximately unbiased estimates. We apply our method to the NICU study and find evidence that high-level NICUs significantly reduce deaths for babies of small gestational age, whereas for almost mature babies like 37 weeks, the level of NICUs makes little difference. A sensitivity analysis is conducted to assess the sensitivity of our conclusions to key assumptions about the missing covariates. The method we develop in this paper may be useful for many observational studies facing similar issues of unmeasured confounders and nonignorable missing data as ours.
Recommendations
- Instrumental variable estimation with a stochastic monotonicity assumption
- Robust Causal Inference with Continuous Instruments Using the Local Instrumental Variable Curve
- Survivor-complier effects in the presence of selection on treatment, with application to a study of prompt ICU admission
- A general instrumental variable framework for regression analysis with outcome missing not at random
- Identification of causal effects in the presence of nonignorable missing outcome values
Cites work
- Addressing complications of intention-to-treat analysis in the combined presence of all-or-none treatment-noncompliance and subsequent missing outcomes
- An Extended General Location Model for Causal Inferences from Data Subject to Noncompliance and Missing Values
- Analyzing a randomized trial on breast self-examination with noncompliance and missing outcomes
- Building a stronger instrument in an observational study of perinatal care for premature infants
- Clinician preferences and the estimation of causal treatment differences. (With comments)
- Estimating treatment effect heterogeneity in randomized program evaluation
- Estimation of causal effects using instrumental variables with nonignorable missing covariates: application to effect of type of delivery NICU on premature infants
- scientific article; zbMATH DE number 1294360 (Why is no real title available?)
- scientific article; zbMATH DE number 1834445 (Why is no real title available?)
- Identifiability and Estimation of Causal Effects in Randomized Trials with Noncompliance and Completely Nonignorable Missing Data
- Identification of Causal Effects Using Instrumental Variables
- Multivariate Correlation Models with Mixed Discrete and Continuous Variables
Cited in
(13)- Instrumental variable estimation with a stochastic monotonicity assumption
- Estimation of causal effects using instrumental variables with nonignorable missing covariates: application to effect of type of delivery NICU on premature infants
- The benefits of prenatal care: evidence from the PAT bus strike
- Semiparametric Inference of Causal Effect with Nonignorable Missing Confounders
- Bayesian scalar on image regression with nonignorable nonresponse
- Building a stronger instrument in an observational study of perinatal care for premature infants
- Instrumental variable analysis for cost outcome: Application to the effect of primary care visit on medical cost among low‐income adults
- Likelihood identifiability and parameter estimation with nonignorable missing data
- Instrumental Variable Estimation of Marginal Structural Mean Models for Time-Varying Treatment
- Nonignorable Missing Data, Single Index Propensity Score and Profile Synthetic Distribution Function
- Manipulating an Instrumental Variable in an Observational Study of Premature Babies: Design, Bounds, and Inference
- Mediation Analysis with the Mediator and Outcome Missing Not at Random
- Variability in causal effects and noncompliance in a multisite trial: a bivariate hierarchical generalized random coefficients model for a binary outcome
This page was built for publication: Estimation of causal effects using instrumental variables with nonignorable missing covariates: application to effect of type of delivery NICU on premature infants
Report a bug (only for logged in users!)Click here to report a bug for this page (MaRDI item Q2453655)
