Traffic-related injuries represent a global public health problem, and contribute largely to mortality and years lived with disability worldwide. Over the course of the last decades, improvements to road traffic safety and injury surveillance systems have resulted in a shift in focus from the prevention of motor vehicle accidents to the control of injury events involving vulnerable road users (VRUs), such as cyclists and moped riders. There have been calls for improvements to the evaluation of safety interventions due to methodological problems associated with the most commonly used study designs. The purpose of this licentiate thesis was to assess the strengths and limitations of the interrupted time series (ITS) design, which has gained some attention for its ability to provide valid effect estimates. Two national road safety interventions involving VRUs were selected as cases: the Swedish bicycle helmet law for children under the age 15, and the tightening of licensing rules for Class 1 mopeds. The empirical results suggest that both interventions were effective in improving the safety of VRUs. Unless other concurrent events affect the treatment population at the exact time of intervention, the effect estimates should be internally valid. One of the main limitations of the study design is the inability to identify why the interventions were successful, especially if they are complex and multifaceted. A lack of reliable exposure data can also pose a further threat to studies of interventions involving VRUs if the intervention can affect the exposure itself. It may also be difficult to generalize the exact effect estimates to other regions and populations. Future studies should consider the use of the ITS design to enhance the internal validity of before-after measurements. / Traffic-related injuries represent a global public health problem, and contribute largely to mortality and years lived with disability. Over the course of the last decades, improvements to road traffic safety and injury surveillance systems have resulted in a shift in focus from motor vehicle accidents to injury events involving vulnerable road users (VRUs), such as cyclists and moped riders. There have been calls for improvements to the evaluation of safety interventions due to methodological problems associated with the most commonly used study designs. The purpose of this licentiate thesis was to assess the strengths and limitations of the interrupted time series (ITS) design, which has gained some attention for its ability to provide valid effect estimates while accounting for secular trends. Two national interventions involving VRUs were selected as cases: the Swedish bicycle helmet law for children under the age 15, and the tightening of licensing rules for Class 1 mopeds. The empirical results suggest that both interventions were effective. These results are discussed in the light of some methodological considerations regarding internal and external validity, data quality and the ability to fully understand key causal mechanisms behind complex interventions.

This thesis develops techniques for adjusting for selection bias using Gaussian process models. Selection bias is a key issue both in sample surveys and in observational studies for causal inference. Despite recently emerged techniques for dealing with selection bias in high-dimensional or complex situations, use of Gaussian process models and Bayesian hierarchical models in general has not been explored. Three approaches are developed for using Gaussian process models to estimate the population mean of a response variable with binary selection mechanism. The first approach models only the response with the selection probability being ignored. The second approach incorporates the selection probability when modeling the response using dependent Gaussian process priors. The third approach uses the selection probability as an additional covariate when modeling the response. The third approach requires knowledge of the selection probability, while the second approach can be used even when the selection probability is not available. In addition to these Gaussian process approaches, a new version of the Horvitz-Thompson estimator is also developed, which follows the conditionality principle and relates to importance sampling for Monte Carlo simulations. Simulation studies and the analysis of an example due to Kang and Schafer show that the Gaussian process approaches that consider the selection probability are able to not only correct selection bias effectively, but also control the sampling errors well, and therefore can often provide more efficient estimates than the methods tested that are not based on Gaussian process models, in both simple and complex situations. Even the Gaussian process approach that ignores the selection probability often, though not always, performs well when some selection bias is present. These results demonstrate the strength of Gaussian process models in dealing with selection bias, especially in high-dimensional or complex situations. These results also demonstrate that Gaussian process models can be implemented rather effectively so that the benefits of using Gaussian process models can be realized in practice, contrary to the common belief that highly flexible models are too complex to use practically for dealing with selection bias.

abstract: Recent advances in hierarchical or multilevel statistical models and causal inference using the potential outcomes framework hold tremendous promise for mock and real jury research. These advances enable researchers to explore how individual jurors can exert a bottom-up effect on the jury’s verdict and how case-level features can exert a top-down effect on a juror’s perception of the parties at trial. This dissertation explains and then applies these technical advances to a pre-existing mock jury dataset to provide worked examples in an effort to spur the adoption of these techniques. In particular, the paper introduces two new cross-level mediated effects and then describes how to conduct ecological validity tests with these mediated effects. The first cross-level mediated effect, the a1b1 mediated effect, is the juror level mediated effect for a jury level manipulation. The second cross-level mediated effect, the a2bc mediated effect, is the unique contextual effect that being in a jury has on the individual the juror. When a mock jury study includes a deliberation versus non-deliberation manipulation, the a1b1 can be compared for the two conditions, enabling a general test of ecological validity. If deliberating in a group generally influences the individual, then the two indirect effects should be significantly different. The a2bc can also be interpreted as a specific test of how much changes in jury level means of this specific mediator effect juror level decision-making. / Dissertation/Thesis / Doctoral Dissertation Psychology 2015

abstract: In investigating mediating processes, researchers usually use randomized experiments and linear regression or structural equation modeling to determine if the treatment affects the hypothesized mediator and if the mediator affects the targeted outcome. However, randomizing the treatment will not yield accurate causal path estimates unless certain assumptions are satisfied. Since randomization of the mediator may not be plausible for most studies (i.e., the mediator status is not randomly assigned, but self-selected by participants), both the direct and indirect effects may be biased by confounding variables. The purpose of this dissertation is (1) to investigate the extent to which traditional mediation methods are affected by confounding variables and (2) to assess the statistical performance of several modern methods to address confounding variable effects in mediation analysis. This dissertation first reviewed the theoretical foundations of causal inference in statistical mediation analysis, modern statistical analysis for causal inference, and then described different methods to estimate causal direct and indirect effects in the presence of two post-treatment confounders. A large simulation study was designed to evaluate the extent to which ordinary regression and modern causal inference methods are able to obtain correct estimates of the direct and indirect effects when confounding variables that are present in the population are not included in the analysis. Five methods were compared in terms of bias, relative bias, mean square error, statistical power, Type I error rates, and confidence interval coverage to test how robust the methods are to the violation of the no unmeasured confounders assumption and confounder effect sizes. The methods explored were linear regression with adjustment, inverse propensity weighting, inverse propensity weighting with truncated weights, sequential g-estimation, and a doubly robust sequential g-estimation. Results showed that in estimating the direct and indirect effects, in general, sequential g-estimation performed the best in terms of bias, Type I error rates, power, and coverage across different confounder effect, direct effect, and sample sizes when all confounders were included in the estimation. When one of the two confounders were omitted from the estimation process, in general, none of the methods had acceptable relative bias in the simulation study. Omitting one of the confounders from estimation corresponded to the common case in mediation studies where no measure of a confounder is available but a confounder may affect the analysis. Failing to measure potential post-treatment confounder variables in a mediation model leads to biased estimates regardless of the analysis method used and emphasizes the importance of sensitivity analysis for causal mediation analysis. / Dissertation/Thesis / Ph.D. Psychology 2013

The inference of gene regulatory networks (GRN) is of great importance to medical research, as causal mechanisms responsible for phenotypes are unravelled and potential therapeutical targets identified. In type 1 diabetes, insulin producing pancreatic beta-cells are the target of an auto-immune attack leading to apoptosis (cell suicide). Although key genes and regulations have been identified, a precise characterization of the process leading to beta-cell apoptosis has not been achieved yet. The inference of relevant molecular pathways in type 1 diabetes is then a crucial research topic. GRN inference from gene expression data (obtained from microarrays and RNA-seq technology) is a causal inference problem which may be tackled with well-established statistical and machine learning concepts. In particular, the use of time series facilitates the identification of the causal direction in cause-effect gene pairs. However, inference from gene expression data is a very challenging problem due to the large number of existing genes (in human, over twenty thousand) and the typical low number of samples in gene expression datasets. In this context, it is important to correctly assess the accuracy of network inference methods. The contributions of this thesis are on three distinct aspects. The first is on inference assessment using precision-recall curves, in particular using the area under the curve (AUPRC). The typical approach to assess AUPRC significance is using Monte Carlo, and a parametric alternative is proposed. It consists on deriving the mean and variance of the null AUPRC and then using these parameters to fit a beta distribution approximating the true distribution. The second contribution is an investigation on network inference from time series. Several state of the art strategies are experimentally assessed and novel heuristics are proposed. One is a fast approximation of first order Granger causality scores, suited for GRN inference in the large variable case. Another identifies co-regulated genes (ie. regulated by the same genes). Both are experimentally validated using microarray and simulated time series. The third contribution of this thesis is on the context of type 1 diabetes and is a study on beta cell gene expression after exposure to cytokines, emulating the mechanisms leading to apoptosis. 8 datasets of beta cell gene expression were used to identify differentially expressed genes before and after 24h, which were functionally characterized using bioinformatics tools. The two most differentially expressed genes, previously unknown in the type 1 Diabetes literature (RIPK2 and ELF3) were found to modulate cytokine induced apoptosis. A regulatory network was then inferred using a dynamic adaptation of a state of the art network inference method. Three out of four predicted regulations (involving RIPK2 and ELF3) were experimentally confirmed, providing a proof of concept for the adopted approach. / Doctorat en Sciences / info:eu-repo/semantics/nonPublished

This dissertation provides three novel methodologies to the field of political science. In the first chapter, I describe how to make causal inferences in the face of dynamic strategies. Traditional causal inference methods assume that these dynamic decisions are made all at once, an assumption that forces a choice between omitted variable bias and post-treatment bias. I resolve this dilemma by adapting methods from biostatistics and use these methods to estimate the effectiveness of an inherently dynamic process: a candidate's decision to "go negative." Drawing on U.S. statewide elections (2000-2006), I find, in contrast to the previous literature, that negative advertising is an effective strategy for non-incumbents. In the second chapter, I develop a method for handling measurement error. Social scientists devote considerable effort to mitigating measurement error during data collection but then ignore the issue during analysis. Although many statistical methods have been proposed for reducing measurement error-induced biases, few have been widely used because implausible assumptions, high levels of model dependence, difficult computation, or inapplicability with multiple mismeasured variables. This chapter develops an easy-to-use alternative without these problems as a special case of extreme measurement error and corrects for both. In the final chapter, I introduce a model for detecting changepoints in the distribution of contributions data because it allows for overdispersion, a key feature of contributions data. While many extant changepoint models force researchers to choose the number of changepoint ex ante, the game-changers model incorporates a Dirichlet process prior in order to estimate the number of changepoints along with their location. I demonstrate the usefulness of the model in data from the 2012 Republican primary and the 2008 U.S. Senate elections. / Government

La prise de décision médicale se définit par le choix du traitement de la maladie, dans l’attente d’un résultat probable tentant de maximiser les bénéfices sur la santé du patient. Ce choix de traitement doit donc reposer sur les preuves scientifiques de son efficacité, ce qui renvoie à une problématique d’estimation de l’effet-traitement. Dans une première partie, nous présentons, proposons et discutons des méthodes d’inférence causale, permettant d’estimer cet effet-traitement par des approches expérimentales ou observationnelles. Toutefois, les preuves obtenues par ces méthodes fournissent une information sur l’effet-traitement uniquement à l’échelle de la population globale, et non à l’échelle de l’individu. Connaître le devenir probable du patient est essentiel pour adapter une décision clinique. Nous présentons donc, dans une deuxième partie, l’approche par modélisation prédictive, qui a permis une avancée en médecine personnalisée. Les modèles prédictifs fournissent au clinicien une information pronostique pour son patient, lui permettant ensuite le choix d’adapter le traitement. Cependant, cette approche a ses limites, puisque ce choix de traitement repose encore une fois sur des preuves établies en population globale. Dans une troisième partie, nous proposons donc une méthode originale d’estimation de l’effet-traitement individuel, en combinant inférence causale et modélisation prédictive. Dans le cas où un traitement est envisagé, notre approche permettra au clinicien de connaître et de comparer d’emblée le pronostic de son patient « avant traitement » et son pronostic « après traitement ». Huit articles étayent ces approches. / Medical decision-making is defined by the choice of treatment of illness, which attempts to maximize the healthcare benefit, given a probable outcome. The choice of a treatment must be therefore based on a scientific evidence. It refers to a problem of estimating the treatment effect. In a first part, we present, discuss and propose causal inference methods for estimating the treatment effect using experimental or observational designs. However, the evidences provided by these approaches are established at the population level, not at the individual level. Foreknowing the patient’s probability of outcome is essential for adapting a clinical decision. In a second part, we present the approach of predictive modeling, which provided a leap forward in personalized medicine. Predictive models give the patient’s prognosis at baseline and then let the clinician decide on treatment. This approach is therefore limited, as the choice of treatment is still based on evidences stated at the overall population level. In a third part, we propose an original method for estimating the individual treatment effect, by combining causal inference and predictive modeling. Whether a treatment is foreseen, our approach allows the clinician to foreknow and compare both the patient’s prognosis without treatment and the patient’s prognosis with treatment. Within this thesis, we present a series of eight articles.

Mendelian randomization is an epidemiological method for using genetic variationto estimate the causal effect of the change in a modifiable phenotype onan outcome from observational data. A genetic variant satisfying the assumptionsof an instrumental variable for the phenotype of interest can be usedto divide a population into subgroups which differ systematically only in thephenotype. This gives a causal estimate which is asymptotically free of biasfrom confounding and reverse causation. However, the variance of the causalestimate is large compared to traditional regression methods, requiring largeamounts of data and necessitating methods for efficient data synthesis. Additionally,if the association between the genetic variant and the phenotype is notstrong, then the causal estimates will be biased due to the “weak instrument”in finite samples in the direction of the observational association. This biasmay convince a researcher that an observed association is causal. If the causalparameter estimated is an odds ratio, then the parameter of association willdiffer depending on whether viewed as a population-averaged causal effect ora personal causal effect conditional on covariates. We introduce a Bayesian framework for instrumental variable analysis, whichis less susceptible to weak instrument bias than traditional two-stage methods,has correct coverage with weak instruments, and is able to efficiently combinegene–phenotype–outcome data from multiple heterogeneous sources. Methodsfor imputing missing genetic data are developed, allowing multiple genetic variantsto be used without reduction in sample size. We focus on the question ofa binary outcome, illustrating how the collapsing of the odds ratio over heterogeneousstrata in the population means that the two-stage and the Bayesianmethods estimate a population-averaged marginal causal effect similar to thatestimated by a randomized trial, but which typically differs from the conditionaleffect estimated by standard regression methods. We show how thesemethods can be adjusted to give an estimate closer to the conditional effect. We apply the methods and techniques discussed to data on the causal effect ofC-reactive protein on fibrinogen and coronary heart disease, concluding withan overall estimate of causal association based on the totality of available datafrom 42 studies.

Noncompliance to treatment allocation is likely to complicate estimation of causal effects in clinical trials. The ubiquitous nonrandom phenomenon of noncompliance renders per-protocol and as- treated analyses or even simple regression adjustments for noncompliance inadequate for causal inference. For survival data, several specialist methods have been developed when noncompliance is related to risk. The Causal Accelerated Life Model (CALM) allows time-dependent departures from randomized treatment in either arm and relates each observed event time to a potential event time that would have been observed if the control treatment had been given throughout the trial. Alternatively, the structural Proportional Hazards (C-Prophet) model accounts for all-or-nothing noncompliance in the treatment arm only while the CHARM estimator allows time-dependent departures from randomized treatment by considering survival outcome as a sequence of binary outcomes to provide an 'approximate' overall hazard ratio estimate which is adjusted for compliance. The problem of efficacy estimation is compounded for two-active treatment trials (additional noncompliance) where the ITT estimate provides a biased estimator for the true hazard ratio even under homogeneous treatment effects assumption. Using plausible arm-specific predictors of compliance, principal stratification methods can be applied to obtain principal effects for each stratum. The present work applies the above methods to data from the Esprit trials study which was conducted to ascertain whether or not unopposed oestrogen (hormone replacement therapy - HRT) reduced the risk of further cardiac events in postmenopausal women who survive a first myocardial infarction. We use statistically designed simulation studies to evaluate the performance of these methods in terms of bias and 95% confidence interval coverage. We also apply a principal stratification method to adjust for noncompliance in two treatment arms trial originally developed for binary data for survival analysis in terms of causal risk ratio. In a Bayesian framework, we apply the method to Esprit data to account for noncompliance in both treatment arms and estimate principal effects. We apply statistically designed simulation studies to evaluate the performance of the method in terms of bias in the causal effect estimates for each stratum. ITT analysis of the Esprit data showed the effects of taking HRT tablets was not statistically significantly different from placebo for both all cause mortality and myocardial reinfarction outcomes. Average compliance rate for HRT treatment was 43% and compliance rate decreased as the study progressed. CHARM and C-Prophet methods produced similar results but CALM performed best for Esprit: suggesting HRT would reduce risk of death by 50%. Simulation studies comparing the methods suggested that while both C-Prophet and CHARM methods performed equally well in terms of bias, the CALM method performed best in terms of both bias and 95% confidence interval coverage albeit with the largest RMSE. The principal stratification method failed for the Esprit study possibly due to the strong distribution assumption implicit in the method and lack of adequate compliance information in the data which produced large 95% credible intervals for the principal effect estimates. For moderate value of sensitivity parameter, principal stratification results suggested compliance with HRT tablets relative to placebo would reduce risk of mortality by 43% among the most compliant. Simulation studies on performance of this method showed narrower corresponding mean 95% credible intervals corresponding to the the causal risk ratio estimates for this subgroup compared to other strata. However, the results were sensitive to the unknown sensitivity parameter.

Les études observationnelles en pharmacoépidémiologie sont souvent mises en place pour évaluer un médicament mis sur le marché récemment ou concurrencé par de nombreuses alternatives thérapeutiques. Cette situation conduit à devoir évaluer l'effet d'un médicament dans une cohorte comprenant peu de sujets traités, c'est à dire une population où l'exposition d'intérêt est rare. Afin de prendre en compte les facteurs de confusion dans cette situation, certains auteurs déconseillent l'utilisation du score de propension au profit du score pronostique, mais cette recommandation ne s'appuie sur aucune étude évaluant spécifiquement les faibles prévalences de l'exposition, et ignore le type d'estimation, conditionnelle ou marginale, fournie par chaque méthode d'utilisation du score pronostique.La première partie de ce travail évalue les méthodes basées sur le score de propension pour l'estimation d'un effet marginal en situation d'exposition rare. La deuxième partie évalue les performances des méthodes basées sur le score pronostique rapportées dans la littérature, introduit de nouvelles méthodes basées sur le score pronostique adaptées à l'estimation d'effets conditionnels ou marginaux, et les compare aux performances des méthodes basées sur le score de propension. La dernière partie traite des estimateurs de la variance des effets du traitement. Nous présentons les conséquences liées à la non prise en compte de l'étape d'estimation du score de propension et du score pronostique dans le calcul de la variance. Nous proposons et évaluons de nouveaux estimateurs tenant compte de cette étape. / Pharmacoepidemiologic observational studies are often conducted to evaluate newly marketed drugs or drugs in competition with many alternatives. In such cohort studies, the exposure of interest is rare. To take into account confounding factors in such settings, some authors advise against the use of the propensity score in favor of the prognostic score, but this recommendation is not supported by any study especially focused on infrequent exposures and ignores the type of estimation provided by each prognostic score-based method.The first part of this work evaluates the use of propensity score-based methods to estimate the marginal effect of a rare exposure. The second part evaluates the performance of the prognostic score based methods already reported in the literature, compares them with the propensity score based methods, and introduces some new prognostic score-based methods intended to estimate conditional or marginal effects. The last part deals with variance estimators of the treatment effect. We present the opposite consequences of ignoring the estimation step of the propensity score and the prognostic score. We show some new variance estimators accounting for this step.