Propensity scores: From naive enthusiasm to intuitive understanding
Propensity scores: From naive enthusiasm to intuitive understanding
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DOI：
10.1177/0962280210394483
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发表时间：
2012-06-01
影响因子：
2.3
通讯作者：
Carpenter, James
中科院分区：
文献类型：
--
作者：
Williamson, Elizabeth;Morley, Ruth;Carpenter, James
在存在混杂的情况下，二元暴露对结果的影响的估计通常通过结果回归模型进行。另一种方法是使用倾向评分方法。倾向得分是给定观察到的协变量，接受暴露的条件概率，在没有未测量混杂因素的假设下，可以用来估计暴露的因果效应。在本文中，我们对倾向得分方法进行了非技术和直观的讨论，通过与随机研究类比来激励倾向得分方法的使用，并描述了该方法可以实施的四种主要方法。我们仔细地描述了被估计的总体参数——一个在医学文献中经常被忽视的问题。我们使用一项研究的数据来说明这四种方法，该研究调查了母亲选择提供母乳与婴儿随后的神经发育之间的关系。我们概述了倾向得分方法的有用扩展，并讨论了未来研究的方向。倾向评分方法仍然存在争议，对于何时（如果有的话）应该使用它们来代替传统的结果回归模型，没有达成共识。因此，我们以讨论每种方法的相对优点和缺点作为结束。
Estimation of the effect of a binary exposure on an outcome in the presence of confounding is often carried out via outcome regression modelling. An alternative approach is to use propensity score methodology. The propensity score is the conditional probability of receiving the exposure given the observed covariates and can be used, under the assumption of no unmeasured confounders, to estimate the causal effect of the exposure. In this article, we provide a non-technical and intuitive discussion of propensity score methodology, motivating the use of the propensity score approach by analogy with randomised studies, and describe the four main ways in which this methodology can be implemented. We carefully describe the population parameters being estimated - an issue that is frequently overlooked in the medical literature. We illustrate these four methods using data from a study investigating the association between maternal choice to provide breast milk and the infant's subsequent neurodevelopment. We outline useful extensions of propensity score methodology and discuss directions for future research. Propensity score methods remain controversial and there is no consensus as to when, if ever, they should be used in place of traditional outcome regression models. We therefore end with a discussion of the relative advantages and disadvantages of each.