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research article

Causal inference in continuous time: an example on prostate cancer therapy

Ryalen, Pål Christie
•
Stensrud, Mats Julius  
•
Fosså, Sophie
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2020
Biostatistics

In marginal structural models (MSMs), time is traditionally treated as a discrete parameter. In survival analysis on the other hand, we study processes that develop in continuous time. Therefore, Røysland (2011. A martingale approach to continuous-time marginal structural models. Bernoulli 17, 895–915) developed the continuous-time MSMs, along with continuous-time weights. The continuous-time weights are conceptually similar to the inverse probability weights that are used in discrete time MSMs. Here, we demonstrate that continuous-time MSMs may be used in practice. First, we briefly describe the causal model assumptions using counting process notation, and we suggest how causal effect estimates can be derived by calculating continuous-time weights. Then, we describe how additive hazard models can be used to find such effect estimates. Finally, we apply this strategy to compare medium to long-term differences between the two prostate cancer treatments radical prostatectomy and radiation therapy, using data from the Norwegian Cancer Registry. In contrast to the results of a naive analysis, we find that the marginal cumulative incidence of treatment failure is similar between the strategies, accounting for the competing risk of other death.

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Type
research article
DOI
10.1093/biostatistics/kxy036
Author(s)
Ryalen, Pål Christie
•
Stensrud, Mats Julius  
•
Fosså, Sophie
•
Røysland, Kjetil
Date Issued

2020

Published in
Biostatistics
Volume

21

Issue

1

Start page

172

End page

185

Editorial or Peer reviewed

REVIEWED

Written at

OTHER

EPFL units
BIOSTAT  
Available on Infoscience
October 15, 2020
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/172531
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