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Structural Nested Models for Cluster-Randomized Trials

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Statistical Causal Inferences and Their Applications in Public Health Research

Part of the book series: ICSA Book Series in Statistics ((ICSABSS))

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Abstract

In clinical trials and epidemiologic studies, adherence to the assigned components is not always perfect. In this book chapter, we are interested in estimating the causal effect of cluster-level adherence on an individual-level outcome. Two different methodologies will be provided, based on ordinary and weighted structural nested models (SNMs). We also applied the jackknife to construct confidence intervals. The computation is straightforward with application of instrumental variables software, and the programming schemes are developed for both ordinary and weighted structural nested models. Simulation studies under ordinary structural nested models with different link functions (loglinear SNM, logistic SNM, and linear SNM) were conducted to validate our methods. We then applied the methods to a school-based water, sanitation, and hygiene study to estimate the causal effect of increased adherence to intervention components on student absenteeism. The results calculated from these two methodologies are quite close.

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Author information

Authors and Affiliations

  1. Department of Biostatistics, University of Florida, 2004 Mowry Road, Gainesville, FL, 32611-7450, USA

    Shanjun Helian & Babette A. Brumback

  2. Departments of Environmental Health, Epidemiology, and Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA

    Matthew C. Freeman

  3. Department of Sustainable Development, Appalachian State University, 287 Rivers St, Boone, NC, 28608, USA

    Richard Rheingans (Chair)

Authors
  1. Shanjun Helian
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  2. Babette A. Brumback
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  3. Matthew C. Freeman
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  4. Richard Rheingans
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Corresponding author

Correspondence to Babette A. Brumback .

Editor information

Editors and Affiliations

  1. Department of Epidemiology School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA

    Hua He

  2. Christiana Care Health System, Value Institute, Newark, Delaware, USA

    Pan Wu

  3. School of Social Work and Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, USA

    Ding-Geng (Din) Chen

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Helian, S., Brumback, B.A., Freeman, M.C., Rheingans, R. (2016). Structural Nested Models for Cluster-Randomized Trials. In: He, H., Wu, P., Chen, DG. (eds) Statistical Causal Inferences and Their Applications in Public Health Research. ICSA Book Series in Statistics. Springer, Cham. https://doi.org/10.1007/978-3-319-41259-7_9

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