Assessing the effectiveness of antiretroviral adherence interventions

Using marginal structural models to replicate the findings of randomized controlled trials

Maya L. Petersen, Yue Wang, Mark J. Van Der Laan, David Bangsberg

Research output: Contribution to journalReview article

37 Citations (Scopus)

Abstract

Randomized controlled trials of interventions to improve adherence to antiretroviral medications are not always feasible. Marginal structural models (MSM) are a statistical methodology that aims to replicate the findings of randomized controlled trials using observational data. Under the assumption of no unmeasured confounders, 3 MSM estimators are available to estimate the causal effect of an intervention. Two of these estimators, G-computation and inverse probability of treatment weighted (IPTW), can be implemented using standard software. G-computation relies on fitting a multivariable regression of adherence on the intervention and confounders. Thus, it is related to the standard multivariable regression approach to estimating causal effects. In contrast, IPTW relies on fitting a multivariable logistic regression of the intervention on confounders. This article reviews the implementation of these methods, the assumptions underlying them, and interpretation of results. Findings are illustrated with a theoretic data example in which MSM are used to estimate the effect of a behavioral intervention on adherence to antiretroviral therapy.

Original languageEnglish (US)
JournalJournal of Acquired Immune Deficiency Syndromes
Volume43
Issue numberSUPPL. 1
DOIs
StatePublished - Dec 2006
Externally publishedYes

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Structural Models
Randomized Controlled Trials
Software
Logistic Models
Therapeutics

Keywords

  • Causal inference
  • Counterfactual
  • G-computation
  • HIV
  • Inverse probability of treatment
  • Randomized controlled trial

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Assessing the effectiveness of antiretroviral adherence interventions : Using marginal structural models to replicate the findings of randomized controlled trials. / Petersen, Maya L.; Wang, Yue; Van Der Laan, Mark J.; Bangsberg, David.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 43, No. SUPPL. 1, 12.2006.

Research output: Contribution to journalReview article

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