The analysis of randomized trials is often complicated by the occurrence of intercurrent events and missing values. Even though there are different strategies to address missing values it is still common to require missing values imputation. In the present article we explore the estimation of treatment effects in RCTs from a causal inference perspective under different missing data mechanisms with a particular emphasis on missings not at random (MNAR). By modelling the missingness process with directed acylcic graphs and patient-specific potential response variables, we present a new approach to obtain an unbiased estimation of treatment effects without needing to impute missing values. Additionally, we provide a formal that the average conditional log-odds ratio is a robust measure even under MNAR missing values if adjusted by sufficient confounders.
翻译:随机对照试验的分析常因中间事件和缺失值的出现而变得复杂。尽管存在多种处理缺失值的策略,但通常仍需要进行缺失值填补。本文从因果推断的角度,探讨了在不同缺失数据机制下随机对照试验中治疗效果的估计,特别关注非随机缺失(MNAR)情形。通过使用有向无环图和患者特异性潜在响应变量对缺失过程进行建模,我们提出了一种无需填补缺失值即可获得无偏治疗效果估计的新方法。此外,我们证明,若通过充分的混杂因素进行调整,平均条件对数比值比即使在MNAR缺失值下仍是一个稳健的度量指标。