Epidemiologists and applied statisticians often believe that relative effect measures conditional on covariates, such as risk ratios and mean ratios, are ``transportable'' across populations. Here, we examine the identification of causal effects in a target population using an assumption that conditional relative effect measures (e.g., conditional risk ratios or mean ratios) are transportable from a trial to the target population. We show that transportability for relative effect measures is largely incompatible with transportability for difference effect measures, unless the treatment has no effect on average or one is willing to make even stronger transportability assumptions, which imply the transportability of both relative and difference effect measures. We then describe how marginal causal estimands in a target population can be identified under the assumption of transportability of relative effect measures, when we are interested in the effectiveness of a new experimental treatment in a target population where the only treatment in use is the control treatment evaluated in the trial. We extend these results to consider cases where the control treatment evaluated in the trial is only one of the treatments in use in the target population, under an additional partial exchangeability assumption in the target population (i.e., a partial assumption of no unmeasured confounding in the target population). We also develop identification results that allow for the covariates needed for transportability of relative effect measures to be only a small subset of the covariates needed to control confounding in the target population. Last, we propose estimators that can be easily implemented in standard statistical software.
翻译:流行病学家和实用统计学家往往认为,以共变为条件的相对效果措施,如风险比率和平均比率等,在人口之间是“可运输的”。在这里,我们研究确定目标人群的因果关系,采用的假设是,有条件相对效果措施(例如有条件风险比率或平均比率)可以从试验中迁移到目标人群;我们表明,相对效果措施的可运输性基本上与差异效果措施的可运输性不相容,除非治疗对平均没有影响,或者人们愿意作出更加容易的可运输性假设,这意味着相对和差异效果措施的可运输性。我们然后说明,在假定相对效果措施的可运输性的情况下,如何确定目标人群的因果关系。 我们关心的是,在试验中唯一使用的方法是试验中评估的控制治疗方法的可运输性,我们扩大这些结果的范围,以考虑在试验中评估的控制治疗方法只是目标人群中使用的治疗方法之一,而在目标人群中,根据额外部分互换性假设的相对和差异效应措施的可转移性估计。在假定相对效果措施的可运输目标人群中,我们只能作出最后的可计量的可测量结果。