Individualized treatment decisions can improve health outcomes, but using data to make these decisions in a reliable, precise, and generalizable way is challenging with a single dataset. Leveraging multiple randomized controlled trials allows for the combination of datasets with unconfounded treatment assignment to improve the power to estimate heterogeneous treatment effects. This paper discusses several non-parametric approaches for estimating heterogeneous treatment effects using data from multiple trials. We extend single-study methods to a scenario with multiple trials and explore their performance through a simulation study, with data generation scenarios that have differing levels of cross-trial heterogeneity. The simulations demonstrate that methods that directly allow for heterogeneity of the treatment effect across trials perform better than methods that do not, and that the choice of single-study method matters based on the functional form of the treatment effect. Finally, we discuss which methods perform well in each setting and then apply them to four randomized controlled trials to examine effect heterogeneity of treatments for major depressive disorder.
翻译:个性化治疗决策可以改善健康结果,但是通过单个数据集来可靠、精确、泛化地做出这些决策具有挑战性。利用多个随机对照试验可以将具有无偏的治疗分配的数据集组合起来,从而提高估算异质性治疗效应的能力。本文讨论了多个非参数方法来估算使用多个试验数据大量估算异质性治疗效应。我们将单一研究的方法扩展到多个试验的情况,并通过模拟研究探讨其性能,生成具有不同级别的跨试验异质性的数据生成场景。模拟表明,直接允许跨试验治疗效应异质性的方法比不允许的方法表现更好,并且单一研究方法的选择取决于治疗效应的函数形式。最后,我们讨论了哪些方法在每种情况下表现良好,并将其应用于四个随机对照试验,以查看治疗重性抑郁障碍的效应异质性。