Variance estimation when using inverse probability of treatment weighting (IPTW) with survival analysis

• Published in: Statistics in medicine Vol. 35; no. 30; pp. 5642 - 5655
• Main Author: Austin, Peter C.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 30.12.2016; Wiley Subscription Services, Inc; John Wiley and Sons Inc
• Subjects: Confidence intervals; Estimating techniques; Humans; inverse probability of treatment weighting (IPTW); Medical statistics; Medical treatment; Monte Carlo Method; Monte Carlo simulation; Monte Carlo simulations; Mortality; observational study; Propensity Score; Proportional Hazards Models; Survival Analysis; variance estimation; Monte Carlo simulations; survival analysis; variance estimation; inverse probability of treatment weighting (IPTW); observational study; propensity score
• DOI: 10.1002/sim.7084
• ISSN: 0277-6715; 1097-0258

Propensity score methods are used to reduce the effects of observed confounding when using observational data to estimate the effects of treatments or exposures. A popular method of using the propensity score is inverse probability of treatment weighting (IPTW). When using this method, a weight is calculated for each subject that is equal to the inverse of the probability of receiving the treatment that was actually received. These weights are then incorporated into the analyses to minimize the effects of observed confounding. Previous research has found that these methods result in unbiased estimation when estimating the effect of treatment on survival outcomes. However, conventional methods of variance estimation were shown to result in biased estimates of standard error. In this study, we conducted an extensive set of Monte Carlo simulations to examine different methods of variance estimation when using a weighted Cox proportional hazards model to estimate the effect of treatment. We considered three variance estimation methods: (i) a naïve model‐based variance estimator; (ii) a robust sandwich‐type variance estimator; and (iii) a bootstrap variance estimator. We considered estimation of both the average treatment effect and the average treatment effect in the treated. We found that the use of a bootstrap estimator resulted in approximately correct estimates of standard errors and confidence intervals with the correct coverage rates. The other estimators resulted in biased estimates of standard errors and confidence intervals with incorrect coverage rates. Our simulations were informed by a case study examining the effect of statin prescribing on mortality. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.