Double Bias: Estimation of Causal Effects from Length-Biased Samples in the Presence of Confounding

Ertefaie Ashkan (), Asgharian Masoud () and Stephens David A. ()
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Ertefaie Ashkan: Department of Statistics, University of Pennsylvania, Philadelphia, PA, USA
Asgharian Masoud: Department of Mathematics and Statistics, McGill University, Montréal, QC, Canada
Stephens David A.: Department of Mathematics and Statistics, McGill University, Montréal, QC, Canada

The International Journal of Biostatistics, 2015, vol. 11, issue 1, 69-89

Abstract: Length bias in survival data occurs in observational studies when, for example, subjects with shorter lifetimes are less likely to be present in the recorded data. In this paper, we consider estimating the causal exposure (treatment) effect on survival time from observational data when, in addition to the lack of randomization and consequent potential for confounding, the data constitute a length-biased sample; we hence term this a double-bias problem. We develop estimating equations that can be used to estimate the causal effect indexing the structural Cox proportional hazard and accelerated failure time models for point exposures in double-bias settings. The approaches rely on propensity score-based adjustments, and we demonstrate that estimation of the propensity score must be adjusted to acknowledge the length-biased sampling. Large sample properties of the estimators are established and their small sample behavior is studied using simulations. We apply the proposed methods to a set of, partly synthesized, length-biased survival data collected as part of the Canadian Study of Health and Aging (CSHA) to compare survival of subjects with dementia among institutionalized patients versus those recruited from the community and depict their adjusted survival curves.

Keywords: Causal Inference; Length-biased Sampling; Propensity Score; Cox Proportional Hazard model; Accelerated Failure Time model. (search for similar items in EconPapers)
Date: 2015
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DOI: 10.1515/ijb-2014-0037

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