ArticleEpidemiology (Cambridge, Mass.)2015
Definition and evaluation of the monotonicity condition for preference-based instruments.
Article in Epidemiology (Cambridge, Mass.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Reporting methodological issues of the mendelian randomization studies in health and medical research: a systematic review.BMC medical research methodology · 2022Pooled it
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- Effect of ADHD medication on risk of injuries: a preference-based instrumental variable analysis.European child & adolescent psychiatry · 2024Article
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- The comparison of caesarean section bleeding between volatile and total intravenous anaesthesia in a Japanese nationwide database.European journal of anaesthesiology and intensive care · 2023Article
- Propensity Score and Instrumental Variable Techniques in Observational Transplantation Studies: An Overview and Worked Example Relating to Pre-Transplant Cardiac Screening.Transplant international : official journal of the European Society for Organ Transplantation · 2022Article
- Diemer and Swanson Reply to "Considerations Before Using Pandemic as Instrument".American journal of epidemiology · 2021Article
- Formulating causal questions and principled statistical answers.Statistics in medicine · 2020Article
- Comparison of Antihypertensive Drug Classes for Dementia Prevention.Epidemiology (Cambridge, Mass.) · 2020Article
- Instrumental variable analyses for causal inference: Application to multilevel analyses of the alliance-outcome relation.Psychotherapy research : journal of the Society for Psychotherapy Research · 2020Article
- Methodological Challenges When Studying Distance to Care as an Exposure in Health Research.American journal of epidemiology · 2019Article
- Causal null hypotheses of sustained treatment strategies: What can be tested with an instrumental variable?European journal of epidemiology · 2018Review
- The challenging interpretation of instrumental variable estimates under monotonicity.International journal of epidemiology · 2018Article
- Understanding the Assumptions Underlying Instrumental Variable Analyses: a Brief Review of Falsification Strategies and Related Tools.Current epidemiology reports · 2018Review
- Adjusting for confounding by indication in observational studies: a case study in traumatic brain injury.Clinical epidemiology · 2018Article
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4 authors.
Funding
Abstract
backgroundPreference-based instrumental variable methods are often used in comparative effectiveness research. Many instrumental variable studies estimate the local average treatment effect (ie, the effect in the "compliers") under the assumption of monotonicity, ie, no "defiers," and well-defined compliance types. However, the monotonicity assumption has not been empirically tested and the meaning of monotonicity itself is unclear.
methodsHere, we clarify the definition of local and global monotonicity and propose a novel study design to assess the monotonicity assumption empirically. Our design requires surveying physicians about their treatment plans and prescribing preferences for the same set of patients. We also discuss measures of monotonicity that can be calculated from this survey data. As an illustration, we conducted a pilot study in a survey of 53 physicians who reported treatment plans and prescribing preferences for hypothetical patients who were candidates for antipsychotic treatment.
resultsIn our study, nearly all patients exhibited some degree of monotonicity violations. In addition, patients could not be cleanly classified as compliers, defiers, always-takers, or never-takers.
conclusionsWe conclude that preference-based instrumental variable estimates should be interpreted cautiously because bias due to monotonicity violations is likely and because the subpopulation to which the estimate applies may not be well defined. Investigators using preference-based instruments may consider supplementing their study with a survey to empirically assess the magnitude and direction of bias due to violations of monotonicity.
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