Evidence map›Paper›PMID 40675767›Full record

ArticleStatistics in medicine2025

Performance of Cross-Validated Targeted Maximum Likelihood Estimation.

Matthew J Smith, Rachael V Phillips, Camille Maringe, Miguel Angel Luque-Fernandez

Abstract read
In one paragraph

Article in Statistics in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Matthew J SmithDepartment of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.ORCID https://orcid.org/0000-0002-8502-0056
Rachael V PhillipsDepartment of Biostatistics, School of Public Health, University of California at Berkeley, Berkeley, California, USA.
Camille MaringeInequalities in Cancer Outcomes Network, London School of Hygiene and Tropical Medicine, London, UK.ORCID https://orcid.org/0000-0002-8739-9565
Miguel Angel Luque-FernandezInequalities in Cancer Outcomes Network, London School of Hygiene and Tropical Medicine, London, UK.

Funding

Cancer Research UK Population Research Committee Programme C7923/A29018Medical Research Council CMIN/AEI/10.13039/501100011033Medical Research Council MR/W021021/1
6 · The paper itself

Abstract

backgroundAdvanced methods for causal inference, such as targeted maximum likelihood estimation (TMLE), require specific convergence rates and the Donsker class condition for valid statistical estimation and inference. In situations where there is no differentiability due to data sparsity or near-positivity violations, the Donsker class condition is violated. In such instances, the bias of the targeted estimand is inflated, and its variance is anti-conservative, leading to poor coverage. Cross-validation of the TMLE algorithm (CVTMLE) is a straightforward, yet effective way to ensure efficiency, especially in settings where the Donsker class condition is violated, such as random or near-positivity violations. We aim to investigate the performance of CVTMLE compared to TMLE in various settings.

methodsWe utilized the data-generating mechanism described in Leger et al. (2022) to run a Monte Carlo experiment under different Donsker class violations. Then, we evaluated the respective statistical performances of TMLE and CVTMLE with different super learner libraries, with and without regression tree methods.

resultsWe found that CVTMLE vastly improves confidence interval coverage without adversely affecting bias, particularly in settings with small sample sizes and near-positivity violations. Furthermore, incorporating regression trees using standard TMLE with ensemble super learner-based initial estimates increases bias and reduces variance, leading to invalid statistical inference.

conclusionsWe show through simulations that CVTMLE is much less sensitive to the choice of the super learner library and thereby provides better estimation and inference in cases where the super learner library uses more flexible candidates and is prone to overfitting.

Indexed as

AlgorithmsLikelihood FunctionsBiasCausalityComputer SimulationModels, StatisticalMonte Carlo Methodcausal inferencedata sparsityDonsker class conditionepidemiologynear‐positivity violationobservational studiestargeted maximum likelihood estimation

Identifiers

PMID40675767
PMCPMC12270713

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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.