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research article

A positivity robust strategy to study effects of switching treatment

Janvin, Matias
•
Ryalen, Pål C.
•
Sarvet, Aaron L.
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September 1, 2025
Biometrics

In studies of medical treatments, individuals often experience post-treatment events that predict their future outcomes. In this work, we study how to use initial observations of a recurrent event - a type of post-treatment event - to offer updated treatment recommendations in settings where no, or few, individuals are observed to switch between treatment arms. Specifically, we formulate an estimand quantifying the average effect of switching treatment on subsequent events. We derive bounds on the value of this estimand under plausible conditions and propose non-parametric estimators of the bounds. Furthermore, we define a value and regret function for a dynamic treatment-switching regime, and use these to determine 3 types of optimal regimes under partial identification: the pessimist (maximin value), optimist (maximax value), and opportunist (minimax regret) regimes. The pessimist regime is guaranteed to perform at least as well as the standard of care. We apply our methods to data from the Systolic Blood Pressure Intervention Trial.

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Type
research article
DOI
10.1093/biomtc/ujaf085
Scopus ID

2-s2.0-105011758846

PubMed ID

40705490

Author(s)
Janvin, Matias

Universitetet i Oslo

Ryalen, Pål C.

Universitetet i Oslo

Sarvet, Aaron L.

University of Massachusetts Amherst

Stensrud, Mats J.  

École Polytechnique Fédérale de Lausanne

Date Issued

2025-09-01

Published in
Biometrics
Volume

81

Issue

3

Article Number

ujaf085

Subjects

causal inference

•

decision theory

•

dynamic treatment strategies

•

recurrent events

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
BIOSTAT  
FunderFunding(s)Grant NumberGrant URL

Swiss National Science Foundation

200021_207436

Available on Infoscience
August 20, 2025
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/253205
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