Direct and indirect treatment effects in the presence of semicompeting risks

Semicompeting risks refer to the phenomenon that the terminal event (such as death) can censor the nonterminal event (such as disease progression) but not vice versa. The treatment effect on the terminal event can be delivered either directly following the treatment or indirectly through the nonterm...

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Bibliographic Details
Published in:Biometrics 2024-03, Vol.80 (2)
Main Authors: Deng, Yuhao, Wang, Yi, Zhou, Xiao-Hua
Format: Article
Language:English
Subjects:
Biometry - methods
Computer Simulation
Humans
Mediation Analysis
Models, Statistical
Randomized Controlled Trials as Topic - statistics & numerical data
Risk
Treatment Outcome
Citations: Items that this one cites
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Summary:Semicompeting risks refer to the phenomenon that the terminal event (such as death) can censor the nonterminal event (such as disease progression) but not vice versa. The treatment effect on the terminal event can be delivered either directly following the treatment or indirectly through the nonterminal event. We consider 2 strategies to decompose the total effect into a direct effect and an indirect effect under the framework of mediation analysis in completely randomized experiments by adjusting the prevalence and hazard of nonterminal events, respectively. They require slightly different assumptions on cross-world quantities to achieve identifiability. We establish asymptotic properties for the estimated counterfactual cumulative incidences and decomposed treatment effects. We illustrate the subtle difference between these 2 decompositions through simulation studies and two real-data applications in the Supplementary Materials.
ISSN:0006-341X
1541-0420
DOI:10.1093/biomtc/ujae032