Causal mediation analysis with mediator values below an assay limit.

Causal mediation analysis with mediator values below an assay limit.
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因果中介分析,中介值低于测定限度。

DOI:
10.1002/sim.10065
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发表时间:
2024
影响因子:
2
通讯作者:
Lok,JudithJ
Lok,JudithJ
中科院分区:
医学3区
文献类型:
--
作者:
Chernofsky,Ariel;Bosch,RonaldJ;Lok,JudithJ

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因果间接效应和直接效应提供了一种可解释的方法,用于将暴露对结果的总效应分解为通过中介的间接效应和通过所有其他途径的直接效应。在随机临床试验中,介质的自然选择是治疗的靶向生物标志物。然而,当介体是生物标志物时,值可以受到测定下限的影响。介体受治疗的影响,并且是结果的假定原因,因此测定下限在介体分析中呈现出复杂的问题。我们提出了两种方法来估计间接和直接影响的中介受到检测限制:(1)外推和(2)数值优化和集成的观察到的可能性。由于这些估计方法仅依赖于所谓的中介公式,因此它们适用于大多数因果中介分析方法:自然的,可分离的和有机的间接和直接影响。一项模拟研究比较了两种估算方法,以一半的检测限进行插补。使用Li et al 2016,AIDS; Lok and Bosch 2021,Epidemiology中描述的AIDS临床试验组的HIV中断研究数据,我们通过估计假设的HIV治愈性治疗对两种HIV持续性指标介导的病毒抑制的有机/纯间接效应来说明我们的方法:细胞相关HIV-RNA和单拷贝血浆HIV-RNA。
Causal indirect and direct effects provide an interpretable method for decomposing the total effect of an exposure on an outcome into the indirect effect through a mediator and the direct effect through all other pathways. A natural choice for a mediator in a randomized clinical trial is the treatment's targeted biomarker. However, when the mediator is a biomarker, values can be subject to an assay lower limit. The mediator is affected by the treatment and is a putative cause of the outcome, so the assay lower limit presents a compounded problem in mediation analysis. We propose two approaches to estimate indirect and direct effects with a mediator subject to an assay limit: (1) extrapolation and (2) numerical optimization and integration of the observed likelihood. Since these estimation methods solely rely on the so‐called Mediation Formula, they apply to most approaches to causal mediation analysis: natural, separable, and organic indirect, and direct effects. A simulation study compares the two estimation approaches to imputing with half the assay limit. Using HIV interruption study data from the AIDS Clinical Trials Group described in Li et al 2016, AIDS; Lok and Bosch 2021, Epidemiology, we illustrate our methods by estimating the organic/pure indirect effect of a hypothetical HIV curative treatment on viral suppression mediated by two HIV persistence measures: cell‐associated HIV‐RNA and single‐copy plasma HIV‐RNA.
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