Matching methods for truncation by death problems

TL;DR

This paper introduces matching-based methods to identify and estimate the Survivor Average Causal Effect (SACE) in randomized trials with truncation by death, addressing issues of covariate imbalance among survivors.

Contribution

It develops a novel matching approach for SACE estimation, including practical guidance, sensitivity analysis techniques, and extension to conditional separable effects.

Findings

Matching methods effectively restore covariate balance among survivors.

Simulation studies demonstrate the approach's flexibility and robustness.

Real data analysis illustrates practical application and sensitivity considerations.

Abstract

Even in a carefully designed randomized trial, outcomes for some study participants can be missing, or more precisely, ill-defined, because participants had died prior to date of outcome collection. This problem, known as truncation by death, means that the treated and untreated are no longer balanced with respect to covariates determining survival. Therefore, researchers often utilize principal stratification and focus on the Survivor Average Causal Effect (SACE). The SACE is the average causal effect among the subpopulation that will survive regardless of treatment status. In this paper, we present matching-based methods for SACE identification and estimation. We provide an identification result for the SACE that motivates the use of matching to restore the balance among the survivors. We discuss various practical issues, including the choice of distance measures, possibility of matching with replacement, and post-matching crude and model-based SACE estimators. Simulation studies and data analysis demonstrate the flexibility of our approach. Because the cross-world assumptions needed for SACE identification can be too strong, we also present sensitivity analysis techniques and illustrate their use in real data analysis. Finally, we show how our approach can also be utilized to estimate conditional separable effects, a recently-proposed alternative for the SACE.