Abstract
In this companion article to “Dynamic Regime Marginal Structural Mean Models for Estimation of Optimal Dynamic Treatment Regimes, Part I: Main Content” [Orellana, Rotnitzky and Robins (2010), IJB, Vol. 6, Iss. 2, Art. 7] we present (i) proofs of the claims in that paper, (ii) a proposal for the computation of a confidence set for the optimal index when this lies in a finite set, and (iii) an example to aid the interpretation of the positivity assumption.
Keywords: dynamic treatment regime, double-robust, inverse probability weighted, marginal structural model, optimal treatment regime, causality
1. Introduction
In this companion article to “Dynamic regime marginal structural mean models for estimation of optimal dynamic treatment regimes. Part I: Main Content” (Orellana, Rotnitzky and Robins, 2010) we present (i) proofs of the claims in that paper, (ii) a proposal for the computation of a confidence set for the optimal index when this lies in a finite set, and (iii) an example to aid the interpretation of the positivity assumption.
The notation, definitions and acronyms are the same as in the companion paper. Througout, we refer to the companion article as ORR-I.
2. Proof of Claims in ORR-I
2.1. Proof of Lemma 1
First note that the consistency assumption C implies that the event
is the same as the event
So, with the definitions
we obtain
Next, note that the fact that unless , implies that
Then, it follows from the second to last displayed equality that
So, part 1 of the Lemma is proved if we show that
(1) |
Define for any k = 0, ..., K,
To prove equality (1) first note that,
where the second to last equality follows because given and , is a fixed, i.e. non-random function of and consequently by the sequential randomization assumption, is conditionally independent of AK given and . The last equality follows by the definition of λK (·|·, ·).
We thus arrive at
This proves the result for the case k = K. If k < K – 1, we analyze the conditional expectation of the last equality in a similar fashion. Specifically, following the same steps as in the long sequence of equalities in the second to last display we arrive at
the last equality follows once again from the sequential randomization assumption. This is so because given and , and are fixed, i.e. deterministic, functions of and the SR assumption ensures then that and are conditionally independent of AK–1 given and .
Equality (1) is thus shown by continuing in this fashion recursively for K – 2, K – 3, ..., K – l until l such that K – l = k – 1.
To show Part 2 of the Lemma, note that specializing part 1 to the case k = 0, we obtain
Thus, taking expectations on both sides of the equality in the last display we obtain
This shows part 2 because B is an arbitrary Borel set.
2.2. Proof of the Assertions in Section 3.2, ORR-I
2.2.1. Proof of Item (a)
Lemma 1, part 2 implies that the densities factors as
In particular, the event has probability 1. Consequently,
Therefore,
(2) |
2.2.2. Proof of Item (b)
Lemma 1, part 1 implies that
The left hand side of this equality is equal to
and this coincides with the right hand side of (2) which, as we have just argued, is equal to φk+1 (ōk).
2.3. Proof of Lemma 2 in ORR-I
Let X be the identity random element on and let EPmarg × PX (·) stand for the expectation operation computed under the product law Pmarg × PX for the random vector (O, A, X). Then the restriction stated in 2) is equivalent to
(3) |
and the restriction stated in 3) is equivalent to
(4) |
To show 2) let d (O, A, X) ≡ ωK (ŌK, ĀK) {u (O, A) – hpar (X, Z, β*)}.
(ORR-I, (14)) ⇒ (3).
where the last equality follows because EPmarg × PX [d (O, A, X) |X = x, Z] = EPmarg [d (O, A, x) |Z] by independence of (O, A) with X under the law Pmarg × PX and, by assumption, EPmarg [d (O, A, x) |Z] = 0 μ-a.e.(x) and hence EPmarg [d (O, A, x) |Z] because PX and μ are mutually absolute continuous.
(3) ⇒ (ORR-I, (14)). Define b* (X; Z) = EPmarg × PX [d(O, A, X)|X, Z]. Then,
consequently, EPmarg × PX [d (O, A, X) |X, Z] = 0 with Pmarg × PX prob. 1 which is equivalent to (ORR-I, (14)) because PX is mutually absolutely continuous with μ.
To show 3) redefine d (O, A, X) as ωK (ŌK, ĀK) {u (O, A) − hsem (X, Z, β*)}.
(ORR-1, (15)) ⇒ (4)
where the third equality follows because EPmarg × PX {d (O, A, X) |X = x, Z} = EPmarg {d (O, A, x) |Z} and EPmarg {d (O, A, x) |Z}= q (Z) μ-a.e.(x) and hence PX-a.e.(x) by absolute continuity.
(4) ⇒ (ORR-I, (15)). Define b* (X; Z) = EP × PX [ d(O, A, X)|X, Z]. Then,
Consequently, b* (X, Z) = EPmarg × PX [b* (X, Z) |Z] ≡ q (Z) PX – a.e. (X) and hence μX –a.e. (X) by absolute continuity. The result follows because b* (x, Z) = EPmarg × PX [d (O, A, X) |X = x, Z] = EPmarg [d (O, A, X) |Z].
2.4. Derivation of Some Formulas in Section 5.3, ORR-I
2.4.1. Derivation of Formula (26) in ORR-I
Any element
of the set Λ is the sum of K + 1 uncorrelated terms because for any l, j such that 0 ≤ l < l + j ≤ K + 1,
Thus, Λ is equal to Λ0 ⊕ Λ1 ⊕ . . . ⊕ ΛK where
and ⊕ stands for the direct sum operator. Then,
and it can be easily checked that Π [Q|Λk] = E (Q|Ōk, Āk) – E [Q|Ōk, Āk–1].
2.4.2. Derivation of Formula (27) in ORR-I
Applying formula (26, in ORR-I) we obtain
So, for k = 0, ..., K,
But,
So formula ((27), ORR-I) is proved if we show that
(5) |
This follows immediately from the preceding proof of Result (b) of Section 3.2. Specifically, it was shown there that
Consequently, the left hand side of (5) is equal to
where the last equality follows by the definition of and the fact that (as this is just the function resulting from applying the integration to the utility u (O, A) = 1).
2.4.3. Derivation of Formula (31) in ORR-I
It suffices to show that where
But by definition
where the last equality follows because
2.5. Proof that b·, opt is Optimal
Write for short, β̂· (b) ≡ β̂· (b, d̂·, opt),
We will show that J· (b) = E {Q· (b) Q· (b·, opt)′} for · = par and · = sem. When either model (16, ORR-I) or (29, ORR-I) are correct, β* = β†. Consequently, for · = par we have that Jpar (b) is equal to
For · = sem and with the definitions b͂ (x, Z) ≡ b (x, Z) – b̄ (Z) and Q͂sem (x͂; β†, γ†, τ†) ≡ Qsem (x͂; β†, γ†, τ†) – Q̄sem (x͂; β†, γ†, τ†), the same argument yields Jsem (b) equal to
Now, with varA (β̂· (b)) denoting the asymptotic variance of β̂· (b), we have that from expansion ((32) in ORR-I)
and consequently
Thus, 0 ≤ varA (β̂· (b) – β̂· (b·, opt)) = varA (β̂· (b)) + varA (β̂· (b·, opt) – 2covA (β̂· (b), β̂· (b·, opt)) = varA (β̂· (b)) – varA (β̂· (b·, opt)) which concludes the proof.
3. Confidence Set for xopt (z) when is Finite and h· (z, x; β) is Linear in β
We first prove the assertion that the computation of the confidence set Bb entails an algorithm for determining if the intersection of half spaces in ℜp and a ball in ℜp centered at the origin is non-empty. To do so, first note that linearity implies that for some fixed functions sj, j = 1, ..., p. Let and write . The point xl is in Bb iff
(6) |
Define the p × 1 vector whose jth entry is equal to sj (xl, z) – sj (xk, z), j = 1, ..., p. Define also the vectors and the constants . Then iff . Noting that β in Cb iff is in the ball
we conclude that the condition in the display (6) is equivalent to
The set is a hyper-plane in ℜp which divides the Euclidean space ℜp into two half-spaces, one of which is . Thus, the condition in the last display imposes that the intersection of N – 1 half-spaces (each one defined by the condition for each k) and the ball is non-empty.
Turn now to the construction of a confidence set that includes Bb. Our construction relies on the following Lemma.
Lemma. Let
where u0 is a fixed p × 1 real valued vector and Σ is a fixed non-singular p × p matrix.
Let α be a fixed, non-null, p×1 real valued vector. Let τ0 ≡ α′ u0 and α* = Σ1/2α. Assume that α1 ≠ 0. Let, be the p×1 vector . Let ϒ be the linear space generated by the p×1 vectors , and define
where
Then there exists satisfying
if and only if
Proof
Then, with τ0 ≡ −α′ u0 and α* = Σ1/2α, we conclude that there exists satisfying α′ u = 0 if and only if there exists u* ∈ Rp such that
Now, by the assumption we have −α*′ u* = τ0 iff . Thus, the collection of all vectors u* satisfying −α*′ u* = τ0 is the linear variety
where and ϒ are defined in the statement of the lemma. The vector is the residual from the (Euclidean) projection of into the space ϒ.
Thus, −α*′ u* τ0 iff for some . Consequently, by the orthogonality of with ϒ we have that for u* satisfying −α*′ u* = τ0 it holds that
Therefore, since is unrestricted,
if and only if
(7) |
This concludes the proof of the Lemma.
To construct the set we note that the condition in the display (6) implies the negation, for every subset of , of the statement
(8) |
Thus, suppose that for a given xl we find that (8) holds for some subset of , then we know that xl cannot be in Bb. The proposed confidence set is comprised by the points in for which condition (8) cannot be negated for all subsets . The set is conservative (i.e. it includes Bb but is not necessarily equal to Bb) because the simultaneous negation of the statement (8) for all does not imply the statement (6). To check if condition (8) holds for any given subset and xl, we apply the result of Lemma as follows. We define the vector α ∈ ℝp whose jth component is equal to , j = 1,..., p and the vector . We also define the constant , and the matrix Σ = Γ̂· (b). We compute the vectors , and the matrix V* as defined in Lemma. We then check if the condition (7) holds. If it holds then this implies that the hyperplane comprised by the set of β’s that satisfy the condition in display (8) with the < sign replaced by the = sign, intersects the confidence ellipsoid Cb, in which case we know that (8) is false. If it does not hold, then we check if condition
(9) |
holds. If (9) does not hold, then we conclude that (8) is false for this choice of . If (9) holds, then we conclude that (8) is true and we then exclude xl from the set .
4. Positivity Assumption: Example
Suppose that K = 1 and that with probability 1 for k = 0, 1, so that no subject dies in neither the actual world nor in the hypothetical world in which g is enforced in the population. Thus, for k = 0, 1, Ok = Lk since both Tk and Rk are deterministic and hence can be ignored. Suppose that Lk and Ak are binary variables (and so are therefore and ) and that the treatment regime g specifies that
Assume that
(10) |
Assumption PO imposes two requirements,
(11) |
(12) |
Because by definition of regime g, , then requirement (11) can be re-expressed as
Since indicators can only take the values 0 or 1 and , l0 = 0, 1 (by assumption (10)), the preceding equality is equivalent to
that is to say,
By the definition of λ0 (·|·) (see (3) in ORR-I), the last display is equivalent to
(13) |
Likewise, because , and because by the fact that , requirement (12) can be re-expressed as
or equivalently, (again because the events and have the same probability by ,
Under the assumption (10), the last display is equivalent to
which, by the definition of λ0 (·|·, ·, ·) in ((3), ORR-I), is, in turn, the same as
(14) |
We conclude that in this example, the assumption PO is equivalent to the conditions (13) and (14). We will now analyze what these conditions encode.
Condition (13) encodes two requirements:
i) the requirement that in the actual world there exist subjects with L0 = 1 and L0 = 0 (i.e. that the conditioning events L0 = 1 and L0 = 0 have positive probabilities), for otherwise at least one of the conditional probabilities in (13) would not be defined, and
ii) the requirement that in the actual world there be subjects with L0 = 0 that take treatment A0 = 1 and subjects with L0 = 1 that take treatment A0 = 0, for otherwise at least one of the conditional probabilities in (13) would be 0.
Condition i) is automatically satisfied, i.e. it does not impose a restriction on the law of L0, by the fact that (since baseline covariates cannot be affected by interventions taking place after baseline) and the fact that we have assumed that , l0 = 0, 1.
Condition ii) is indeed a non-trivial requirement and coincides with the interpretation of the PO assumption given in section 3.1 for the case k = 0. Specifically, in the world in which g were to be implemented there would exist subjects with L0 = 0. In such world the subjects with L0 = 0 would take treatment , then the PO assumption for k = 0 requires that in the actual world there also be subjects with L0 = 0 that at time 0 take treatment A0 = 1. Likewise the PO condition also requires that for k = 0 the same be true with 0 and 1 reversed in the right hand side of each of the equalities of the preceding sentence. A key point is that (11) does not require that in the observational world there be subjects with L0 = 0 that take A0 = 0, nor subjects with L0 = 1 that take A1 = 1. The intuition is clear. If we want to learn from data collected in the actual (observational) world what would happen in the hypothetical world in which everybody obeyed regime g, we must observe people in the study that obeyed the treatment at every level of L0 for otherwise if, say, nobody in the actual world with L0 = 0 obeyed regime g there would be no way to learn what the distribution of the outcomes for subjects in that stratum would be if g were enforced. However, we don t care that there be subjects with L0 = 0 that do not obey g, i.e. that take A0 = 0, because data from those subjects are not informative about the distribution of outcomes when g is enforced.
Condition (14) encodes two requirements:
iii) the requirement that in the actual world there be subjects in the four strata (L0 = 0, L1 = 0, A0 = 1), (L0 = 0, L1 = 1, A0 = 1), (L0 = 1, L1 = 0, A0 = 0) and (L0 = 1, L1 = 1, A0 = 0) (i.e. that the conditioning events in the display (14) have positive probabilities), for otherwise at least one of the conditional probabilities would not be defined, and
iv) the requirement that in the actual world there be subjects in every one of the strata (L0 = 0, L1 = 0, A0 = 1), (L0 = 0, L1 = 1, A0 = 1), (L0 = 1, L1 = 1, A0 = 0) that have A1 = 0 at time 1 and the requirement that there be subjects in stratum (L0 = 1, L1 = 0, A0 = 0) that have A1 = 1 at time 1, for otherwise at least one of the conditional probabilities in (14) would be 0.
Given condition ii) and the sequential randomization (SR) and consistency (C) assumptions, condition iii) is automatically satisfied, i.e. it does not impose a further restriction on the joint distribution of (L0, L1, A0). To see this, first note that by condition (ii) the strata (L0 = 0, A0 = 1) and (L0 = 1, A0 = 0) are non-empty. So condition (iii) is satisfied provided
But
and by (10). An analogous argument shows that . Finally, condition (iv) is a formalization our interpretation of assumption PO in section 3.1 for k = 1. In the world in which g was implemented there would exist subjects that would have all four combination of values for . However, subjects with will only have , so in this hypothetical world we will see at time 1 only four possible recorded histories, , , and . In this hypothetical world subjects with any of the first three possible recorded histories will take and subjects with the last one will take . Thus, in the actual world we must require that there be subjects in each of the first three strata (L0 = 0, L1 = 0, A0 = 1), (L0 = 0, L1 = 1, A0 = 1), (L0 = 1, L1 = 0, A0 = 0) that take A1 = 0 and subjects in the stratum (L0 = 1, L1 = 1, A0 = 0) that take A1 = 1. A point of note is that we don t make any requirement about the existence of subjects in strata other than the four mentioned in (iii) or about the treatment that subjects in these remaining strata take. The reason is that subjects that are not in the four strata of condition (iii) have already violated regime g at time 0 so they are uninformative about the outcome distribution under regime g.
Footnotes
This work was supported by NIH grant R01 GM48704.
References
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