Thanks to Tim Morris for letting me know about a paper just published in the journal Clinical Trials by Zhang et al, titled ‘Conditional estimation and inference to address observed covariate imbalance in randomized clinical trials’. Zhang et al propose so called conditional estimation and inference to address observed covariate imbalance in randomised trials. They introduce the setup of randomised trials with covariates , randomised treatment , and outcome . They begin with a framework that treats all three as random in repeated sampling, and review the unadjusted estimator of the marginal mean difference in outcome, and a covariate adjusted estimator based on earlier work by Tsiatis and others.
Propensity scores have become a popular approach for confounder adjustment in observational studies. The basic idea is to model how the probability of receiving a treatment or exposure depends on the confounders, i.e. the ‘propensity’ to be treated. To estimate the effect of exposure, outcomes are then compared between exposed and unexposed who share the same value of the propensity score. Alternatively the outcome can be regressed on exposure, weighting the observations using the propensity score. For further reading on using propensity scores in observational studies, see for example this nice paper by Peter Austin.
But the topic of this post is on the use of propensity scores in randomized controlled trials. The post was prompted by an excellent seminar recently given by my colleague Elizabeth Williamson, covering the content of her recent paper ‘Variance reduction in randomised trials by inverse probability weighting using the propensity score” (open access paper here).