Strategies for evaluating the assumptions of the regression discontinuity design: a case study using a human papillomavirus vaccination programme.
Strategies for evaluating the assumptions of the regression discontinuity design: a case study using a human papillomavirus vaccination programme.
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DOI：
10.1093/ije/dyw195
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发表时间：
2017-06-01
影响因子：
7.7
通讯作者：
Strumpf EC
中科院分区：
文献类型：
--
作者：
Smith LM;Lévesque LE;Kaufman JS;Strumpf EC
背景：断点回归设计（RDD）是一种准实验方法，用于避免评估新政策和干预措施时出现混杂偏差。它特别适用于根据个人是否高于或低于连续测量变量（例如出生日期、收入或体重）预先指定的截止值来分配政策/干预措施的情况。该设计的优势在于，如果个人不操纵该变量的值，则对于接近截止值的个人，政策/干预措施的分配被认为与随机分配一样好。尽管 RDD 在经济学等领域很受欢迎，但它在流行病学领域仍然相对不为人知，而它的应用可能非常有用。 方法：在本文中，我们为健康研究人员提供了 RDD 的实用介绍，描述了设计的四个可实证检验的假设，并提供了可用于评估在给定研究中是否满足这些假设的策略。出于说明目的，我们实施这些策略来评估 RDD 是否适合研究人乳头瘤病毒疫苗接种对宫颈发育不良的影响。 结果：我们发现，虽然 RDD 的假设在我们的研究背景下普遍得到满足，但出生时间有可能以意想不到的方式混淆我们的效应估计，因此需要在分析中考虑在内。 结论：我们的研究结果强调了评估该设计假设的有效性、在可能的情况下对其进行测试并根据需要进行调整以支持有效的因果推理的重要性。
Background: The regression discontinuity design (RDD) is a quasi-experimental approach used to avoid confounding bias in the assessment of new policies and interventions. It is applied specifically in situations where individuals are assigned to a policy/intervention based on whether they are above or below a pre-specified cut-off on a continuously measured variable, such as birth date, income or weight. The strength of the design is that, provided individuals do not manipulate the value of this variable, assignment to the policy/intervention is considered as good as random for individuals close to the cut-off. Despite its popularity in fields like economics, the RDD remains relatively unknown in epidemiology where its application could be tremendously useful. Methods: In this paper, we provide a practical introduction to the RDD for health researchers, describe four empirically testable assumptions of the design and offer strategies that can be used to assess whether these assumptions are met in a given study. For illustrative purposes, we implement these strategies to assess whether the RDD is appropriate for a study of the impact of human papillomavirus vaccination on cervical dysplasia. Results: We found that, whereas the assumptions of the RDD were generally satisfied in our study context, birth timing had the potential to confound our effect estimate in an unexpected way and therefore needed to be taken into account in the analysis. Conclusions: Our findings underscore the importance of assessing the validity of the assumptions of this design, testing them when possible and making adjustments as necessary to support valid causal inference.
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DOI：
10.1136/bmj.g1458
发表时间：
2014-03-04
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Crowe E;Pandeya N;Brotherton JM;Dobson AJ;Kisely S;Lambert SB;Whiteman DC
通讯作者：
Whiteman DC
影响因子：
6.1
作者：
Hahn, JY;Todd, P;Van der Klaauw, W
通讯作者：
Van der Klaauw, W
影响因子：
3.8
作者：
Cook, Thomas D.;Shadish, William R.;Wong, Vivian C.
通讯作者：
Wong, Vivian C.
影响因子：
45.3
作者：
Mahmud, Salaheddin M.;Kliewer, Erich V.;Demers, Alain A.
通讯作者：
Demers, Alain A.
影响因子：
10.3
作者：
Baldur-Felskov, Birgitte;Dehlendorff, Christian;Kjaer, Susanne K.
通讯作者：
Kjaer, Susanne K.