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Causal mediation analysis in the context of clinical research

机译:临床研究中的因果中介分析

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摘要

Clinical researches usually collected numerous intermediate variables besides treatment and outcome. These variables are often incorrectly treated as confounding factors and are thus controlled using a variety of multivariable regression models depending on the types of outcome variable. However, these methods fail to disentangle underlying mediating processes. Causal mediation analysis (CMA) is a method to dissect total effect of a treatment into direct and indirect effect. The indirect effect is transmitted via mediator to the outcome. The mediation package is designed to perform CMA under the assumption of sequential ignorability. It reports average causal mediation effect (ACME), average direct effect (ADE) and total effect. Also, the package provides visualization tool for these estimated effects. Sensitivity analysis is designed to examine whether the results are robust to the violation of the sequential ignorability assumption since the assumption has been criticized to be too strong to be satisfied in research practice.
机译:临床研究通常收集除治疗和结果外的众多中间变量。这些变量通常被错误地视为混杂因素,因此根据结果变量的类型使用各种多元回归模型进行控制。但是,这些方法无法解开底层的中介过程。因果中介分析(CMA)是一种将治疗的总效果分解为直接和间接效果的方法。间接影响通过中介传递给结果。中介程序包旨在在顺序可忽略性的前提下执行CMA。它报告了平均因果中介效应(ACME),平均直接效应(ADE)和总体效应。此外,该软件包还为这些估计的效果提供了可视化工具。灵敏度分析旨在检查结果是否对违反顺序可燃性假设具有鲁棒性,因为该假设已被批评过于强大而无法在研究实践中得到满足。

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