UBC Theses and Dissertations
Bayesian propensity score analysis of observational data McCandless, Lawrence Cruikshank
Propensity scores analysis (PSA) involves regression adjustment for the estimated propensity scores, and the method can be used for estimating causal effects from observational data. However, confidence intervals for the treatment effect may be falsely precise because PSA ignores uncertainty in the estimated propensity scores. We propose Bayesian propensity score analysis (BPSA) for observational studies with a binary treatment, binary outcome and measured confounders. The method uses logistic regression models with the propensity score as a latent variable. The first regression models the relationship between the outcome, treatment and propensity score, while the second regression models the relationship between the propensity score and measured confounders. Markov chain Monte Carlo is used to study the posterior distribution of the exposure effect. We demonstrate BPSA in an observational study of the effect of statin therapy on all-cause mortality in patients discharged from Ontario hospitals following acute myocardial infarction. The results illustrate that BPSA and PSA may give different inferences despite the large sample size. We study performance using Monte Carlo simulations. Synthetic datasets are generated using competing models for the outcome variable and various fixed parameter values. The results indicate that if the outcome regression model is correctly specified, in the sense that the outcome risk within treatment groups is a smooth function of the propensity score, then BPSA permits more efficient estimation of the propensity scores compared to PSA. BPSA exploits prior information about the relationship between the outcome variable and the propensity score. This information is ignored by PSA. Conversely, when the model for the outcome variable is misspecified, then BPSA generally performs worse than PSA.
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