ArticleEpidemiology (Cambridge, Mass.)2022
When Effects Cannot be Estimated: Redefining Estimands to Understand the Effects of Naloxone Access Laws.
Article in Epidemiology (Cambridge, Mass.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed.
- Choosing an analytic approach: key study design considerations in state policy evaluation.Health services & outcomes research methodology · 2026Article
- Article
- Effects of projected increases in heat exposure on linguistic development in two-year-old children: A longitudinal modified treatment policy analysis.Environmental epidemiology (Philadelphia, Pa.) · 2025Article
- Illustrating an Adaptive Prespecification Framework for Observational Research: Target Trial Emulations Comparing Immunomodulator Treatments for COVID-19.Epidemiology (Cambridge, Mass.) · 2025Article
- The effect of lifting eviction moratoria on fatal drug overdoses in the context of the COVID-19 pandemic in the United States.American journal of epidemiology · 2025Article
- Restricting Periodontal Treatment Frequency: Impact on Tooth Loss in Danish Adults.Community dentistry and oral epidemiology · 2025Article
- How do restrictions on opioid prescribing, harm reduction, and treatment coverage policies relate to opioid overdose deaths in the United States in 2013-2020? An application of a new state opioid policy scale.The International journal on drug policy · 2025Article
- Errata to: "lmtp: An R Package for Estimating the Causal Effects of Modified Treatment Policies".Observational studies · 2025Article
- Investigating the complexity of naloxone distribution: Which policies matter for pharmacies and potential recipients.Journal of health economics · 2024Article
- Longitudinal patterns of natural hazard exposures and anxiety and depression symptoms among young adults in four low- and middle-income countries.Scientific reports · 2024Article
- Causal machine learning for predicting treatment outcomes.Nature medicine · 2024Review
- The epidemiologic case for urban health: conceptualizing and measuring the magnitude of challenges and potential benefits.F1000Research · 2024Review
- Naloxone expansion is not associated with increases in adolescent heroin use and injection drug use: Evidence from 44 US states.The International journal on drug policy · 2023Article
- The Future of the United States Overdose Crisis: Challenges and Opportunities.The Milbank quarterly · 2023Article
- A causal roadmap for generating high-quality real-world evidence.Journal of clinical and translational science · 2023Review
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
Violations of the positivity assumption (also called the common support condition) challenge health policy research and can result in significant bias, large variance, and invalid inference. We define positivity in the single- and multiple-timepoint (i.e., longitudinal) health policy evaluation setting, and discuss real-world threats to positivity. We show empirical evidence of the practical positivity violations that can result when attempting to estimate the effects of health policies (in this case, Naloxone Access Laws). In such scenarios, an alternative is to estimate the effect of a shift in law enactment (e.g., the effect if enactment had been delayed by some number of years). Such an effect corresponds to what is called a modified treatment policy, and dramatically weakens the required positivity assumption, thereby offering a means to estimate policy effects even in scenarios with serious positivity problems. We apply the approach to define and estimate the longitudinal effects of Naloxone Access Laws on opioid overdose rates.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.