PD-Robust is a triply robust pseudo-outcome estimator for subgroup-specific effects on recovery trajectories among patients who would survive regardless of exposure, and it identifies males under 85 as losing up to 23 days at home after a hospital-acquired condition.
A Meta-Learning Method for Estimation of Causal Excursion Effects to Assess Time-Varying Moderation
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abstract
Advances in wearable technologies and health interventions delivered by smartphones have greatly increased the accessibility of mobile health (mHealth) interventions. Micro-randomized trials (MRTs) are designed to assess the effectiveness of the mHealth intervention and introduce a novel class of causal estimands called "causal excursion effects." These estimands enable the evaluation of how intervention effects change over time and are influenced by individual characteristics or context. Existing methods for analyzing causal excursion effects assume known randomization probabilities, complete observations, and a linear nuisance function with prespecified features of the high dimensional observed history. However, in complex mobile systems, these assumptions often fall short: randomization probabilities can be uncertain, observations may be incomplete, and the granularity of mHealth data makes linear modeling difficult. To address this issue, we propose a flexible and doubly robust inferential procedure, called "DR-WCLS," for estimating causal excursion effects from a meta-learner perspective. We present the bidirectional asymptotic properties of the proposed estimators and compare them with existing methods both theoretically and through extensive simulations. The results show a consistent and more efficient estimate, even with missing observations or uncertain treatment randomization probabilities. Finally, the practical utility of the proposed methods is demonstrated by analyzing data from a multiinstitution cohort of first-year medical residents in the United States (NeCamp et al., 2020).
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PD-Robust is a triply robust pseudo-outcome estimator for subgroup-specific effects on recovery trajectories among patients who would survive regardless of exposure, and it identifies males under 85 as losing up to 23 days at home after a hospital-acquired condition.