Iván Díaz

Iván Díaz is Assistant Professor of Healthcare Policy & Research at Weill Cornell Medical Center. He received his PhD from the University of California, Berkeley and his master's and undergraduate degrees from the National University of Colombia.

Title: Doubly Robust Inference for Targeted Minimum Loss Based Estimation in Randomized Trials with Missing Outcome Data

Abstract: Missing outcome data is a crucial threat to the validity of treatment effect estimates from randomized trials. The outcome distributions of participants with missing and observed data are often different, which increases bias. Causal inference methods may aid in reducing the bias and improving efficiency by incorporating baseline variables into the analysis. In particular, doubly robust estimators incorporate two nuisance parameters: the outcome regression and the missingness mechanism (i.e., the probability of missingness conditional on treatment assignment and baseline variables), to adjust for differences in the observed and unobserved groups that can be explained by observed covariates. To consistently estimate the treatment effect, one of these nuisance parameters must be consistently estimated. Traditionally, nuisance parameters are estimated using parametric models, which often precludes consistency, particularly in moderate to high dimensions. Recent research on missing data has focused on data-adaptive estimation to help achieve consistency, but the large sample properties of such methods are poorly understood. In this article we discuss a doubly robust estimator that is consistent and asymptotically normal (CAN) under data-adaptive estimation of the nuisance parameters. We provide a formula for an asymptotically exact confidence interval under minimal assumptions. We show that our proposed estimator has smaller finite-sample bias compared to standard doubly robust estimators. We present a simulation study demonstrating the enhanced performance of our estimators in terms of bias, efficiency, and coverage of the confidence intervals. We present the results of an illustrative example: a randomized, double-blind phase II/III trial of antiretroviral therapy in HIV-infected persons.