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Background\\nTo better understand the epidemiology and patterns of tracheostomy practice for patients with acute respiratory distress syndrome (ARDS), we investigated the current usage of tracheostomy in patients with ARDS recruited into the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) study.\\nMethods\\nThis is a secondary analysis of LUNG-SAFE, an international, multicenter, prospective cohort study of patients receiving invasive or noninvasive ventilation in 50 countries spanning 5 continents. The study was carried out over 4 weeks consecutively in the winter of 2014, and 459 ICUs participated. We evaluated the clinical characteristics, management and outcomes of patients that received tracheostomy, in the cohort of patients that developed ARDS on day 1–2 of acute hypoxemic respiratory failure, and in a subsequent propensity-matched cohort.\\nResults\\nOf the 2377 patients with ARDS that fulfilled the inclusion criteria, 309 (13.0%) underwent tracheostomy during their ICU stay. Patients from high-income European countries (n = 198/1263) more frequently underwent tracheostomy compared to patients from non-European high-income countries (n = 63/649) or patients from middle-income countries (n = 48/465). Only 86/309 (27.8%) underwent tracheostomy on or before day 7, while the median timing of tracheostomy was 14 (Q1–Q3, 7–21) days after onset of ARDS. In the subsample matched by propensity score, ICU and hospital stay were longer in patients with tracheostomy. While patients with tracheostomy had the highest survival probability, there was no difference in 60-day or 90-day mortality in either the patient subgroup that survived for at least 5 days in ICU, or in the propensity-matched subsample.\\nConclusions\\nMost patients that receive tracheostomy do so after the first week of critical illness. Tracheostomy may prolong patient survival but does not reduce 60-day or 90-day mortality.

The propensity score plays a central role in a variety of causal inference settings. In particular, matching and weighting methods based on the estimated propensity score have become increasingly common in the analysis of observational data. Despite their popularity and theoretical appeal, the main practical difficulty of these methods is that the propensity score must be estimated. Researchers have found that slight misspecification of the propensity score model can result in substantial bias of estimated treatment effects. We introduce covariate balancing propensity score (CBPS) methodology, which models treatment assignment while optimizing the covariate balance. The CBPS exploits the dual characteristics of the propensity score as a covariate balancing score and the conditional probability of treatment assignment. The estimation of the CBPS is done within the generalized method‐of‐moments or empirical likelihood framework. We find that the CBPS dramatically improves the poor empirical performance of propensity score matching and weighting methods reported in the literature. We also show that the CBPS can be extended to other important settings, including the estimation of the generalized propensity score for non‐binary treatments and the generalization of experimental estimates to a target population. Open source software is available for implementing the methods proposed.

We show that propensity score matching (PSM), an enormously popular method of preprocessing data for causal inference, often accomplishes the opposite of its intended goal—thus increasing imbalance, inefficiency, model dependence, and bias. The weakness of PSM comes from its attempts to approximate a completely randomized experiment, rather than, as with other matching methods, a more efficient fully blocked randomized experiment. PSM is thus uniquely blind to the often large portion of imbalance that can be eliminated by approximating full blocking with other matching methods. Moreover, in data balanced enough to approximate complete randomization, either to begin with or after pruning some observations, PSM approximates random matching which, we show, increases imbalance even relative to the original data. Although these results suggest researchers replace PSM with one of the other available matching methods, propensity scores have other productive uses.

Propensity score matching (PSM) has become a popular technique for estimating average treatment effects (ATEs) in accounting research. In this study, we discuss the usefulness and limitations of PSM relative to more traditional multiple regression (MR) analysis. We discuss several PSM design choices and review the use of PSM in 86 articles in leading accounting journals from 2008–2014. We document a significant increase in the use of PSM from zero studies in 2008 to 26 studies in 2014. However, studies often oversell the capabilities of PSM, fail to disclose important design choices, and/or implement PSM in a theoretically inconsistent manner. We then empirically illustrate complications associated with PSM in three accounting research settings. We first demonstrate that when the treatment is not binary, PSM tends to confine analyses to a subsample of observations where the effect size is likely to be smallest. We also show that seemingly innocuous design choices greatly influence sample composition and estimates of the ATE. We conclude with suggestions for future research considering the use of matching methods.

Establishing causal links when experiments are not feasible is an important challenge for psychology researchers. The question of whether parents’ spanking causes children’s externalizing behavior problems poses such a challenge because randomized experiments of spanking are unethical, and correlational studies cannot rule out potential selection factors. This study used propensity score matching based on the lifetime prevalence and recent incidence of spanking in a large and nationally representative sample (N = 12,112) as well as lagged dependent variables to get as close to causal estimates outside an experiment as possible. Whether children were spanked at the age of 5 years predicted increases in externalizing behavior problems by ages 6 and 8, even after the groups based on spanking prevalence or incidence were matched on a range of sociodemographic, family, and cultural characteristics and children’s initial behavior problems. These statistically rigorous methods yield the conclusion that spanking predicts a deterioration of children’s externalizing behavior over time.

There are many settings where researchers are interested in estimating average treatment effects and are willing to rely on the unconfoundedness assumption, which requires that the treatment assignment be as good as random conditional on pretreatment variables. The unconfoundedness assumption is often more plausible if a large number of pretreatment variables are included in the analysis, but this can worsen the performance of standard approaches to treatment effect estimation. We develop a method for debiasing penalized regression adjustments to allow sparse regression methods like the lasso to be used for √n-consistent inference of average treatment effects in high dimensional linear models. Given linearity, we do not need to assume that the treatment propensities are estimable, or that the average treatment effect is a sparse contrast of the outcome model parameters. Rather, in addition to standard assumptions used to make lasso regression on the outcome model consistent under 1-norm error, we require only overlap, i.e. that the propensity score be uniformly bounded away from 0 and 1. Procedurally, our method combines balancing weights with a regularized regression adjustment.

Background Propensity score matching is a statistical method that is often used to make inferences on the treatment effects in observational studies. In recent years, there has been widespread use of the technique in the cardiothoracic surgery literature to evaluate to potential benefits of new surgical therapies or procedures. However, the small sample size and the strong dependence of the treatment assignment on the baseline covariates that often characterize these studies make such an evaluation challenging from a statistical point of view. In such settings, the use of propensity score matching in combination with oversampling and replacement may provide a solution to these issues by increasing the initial sample size of the study and thus improving the statistical power that is needed to detect the effect of interest. In this study, we review the use of propensity score matching in combination with oversampling and replacement in small sample size settings. Methods We performed a series of Monte Carlo simulations to evaluate how the sample size, the proportion of treated, and the assignment mechanism affect the performances of the proposed approaches. We assessed the performances with overall balance, relative bias, root mean squared error and nominal coverage. Moreover, we illustrate the methods using a real case study from the cardiac surgery literature. Results Matching without replacement produced estimates with lower bias and better nominal coverage than matching with replacement when 1:1 matching was considered. In contrast to that, matching with replacement showed better balance, relative bias, and root mean squared error than matching without replacement for increasing levels of oversampling. The best nominal coverage was obtained by using the estimator that accounts for uncertainty in the matching procedure on sets of units obtained after matching with replacement. Conclusions The use of replacement provides the most reliable treatment effect estimates and that no more than 1 or 2 units from the control group should be matched to each treated observation. Moreover, the variance estimator that accounts for the uncertainty in the matching procedure should be used to estimate the treatment effect.

A large auditing literature concludes that Big N auditors provide higher audit quality than non-Big N auditors. Recently, however, a high-profile study suggests that propensity score matching (PSM) on client characteristics eliminates the Big N effect [Lawrence A, Minutti-Meza M, Zhang P (2011) Can Big 4 versus non-Big 4 differences in audit-quality proxies be attributed to client characteristics? Accounting Rev. 86(1):259–286]. We conjecture that this finding may be affected by PSM’s sensitivity to its design choices and/or by the validity of the audit quality measures used in the analysis. To investigate, we examine random combinations of PSM design choices that achieve covariate balance, and four commonly used audit quality measures. We find that the majority of these design choices support a Big N effect for most of the audit quality measures. Overall, our findings show that it is premature to suggest that PSM eliminates the Big N effect. This paper was accepted by Suraj Srinivasan, accounting .

Propensity score matching estimators (Rosenbaum and Rubin (1983)) are widely used in evaluation research to estimate average treatment effects. In this article, we derive the large sample distribution of propensity score matching estimators. Our derivations take into account that the propensity score is itself estimated in a first step, prior to matching. We prove that first step estimation of the propensity score affects the large sample distribution of propensity score matching estimators, and derive adjustments to the large sample variances of propensity score matching estimators of the average treatment effect (ATE) and the average treatment effect on the treated (ATET). The adjustment for the ATE estimator is negative (or zero in some special cases), implying that matching on the estimated propensity score is more efficient than matching on the true propensity score in large samples. However, for the ATET estimator, the sign of the adjustment term depends on the data generating process, and ignoring the estimation error in the propensity score may lead to confidence intervals that are either too large or too small.

Examining covariate balance is the prescribed method for determining the degree to which propensity score methods should be successful at reducing bias. This study assessed the performance of various balance measures, including a proposed balance measure based on the prognostic score (similar to a disease risk score), to determine which balance measures best correlate with bias in the treatment effect estimate. The correlations of multiple common balance measures with bias in the treatment effect estimate produced by weighting by the odds, subclassification on the propensity score, and full matching on the propensity score were calculated. Simulated data were used, based on realistic data settings. Settings included both continuous and binary covariates and continuous covariates only. The absolute standardized mean difference (ASMD) in prognostic scores, the mean ASMD (in covariates), and the mean t-statistic all had high correlations with bias in the effect estimate. Overall, prognostic scores displayed the highest correlations with bias of all the balance measures considered. Prognostic score measure performance was generally not affected by model misspecification, and the prognostic score measure performed well under a variety of scenarios. Researchers should consider using prognostic score–based balance measures for assessing the performance of propensity score methods for reducing bias in nonexperimental studies.