Assumptions in Causal Inference

Lucy D’Agostino McGowan

Image generated with Gemini

Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood
And looked down one as far as I could
To where it bent in the undergrowth
— Robert Frost

Potential outcomes

  • Prior to some “cause” occurring, the potential outcomes are all of the potential things that could occur depending on what you end up exposed to

Potential outcomes

  • Let’s assume an exposure has two levels:
    • \(X=1\) if you are exposed
    • \(X=0\) if you are not exposed

Potential outcomes

  • Under this simple scenario, there are two potential outcomes:
    • \(Y(1)\) the potential outcome if you are exposed
    • \(Y(0)\) the potential outcome if you are not exposed

Potential outcomes

  • Only one of these potential outcomes will actually be realized
  • It is important to remember here that these exposures are defined at a particular instance in time, so only one can happen to any individual
  • In the case of a binary exposure, this leaves one potential outcome as observable and one missing

Potential outcomes

  • Our causal effect of interest is often some difference in potential outcomes \(Y(1) - Y(0)\), averaged over a particular population

Counterfactuals

  • Early causal inference methods were often framed as missing data problems
  • We need to make certain assumptions about the missing counterfactuals, the value of the potential outcome corresponding to the exposure(s) that did not occur
  • We wish we could observe the conterfactual outcome that would have occurred in an alternate universe

Counterfactuals

  • To do this, we attempt to control for all factors that are related to an exposure and outcome such that we can construct (or estimate) such a counterfactual outcome.

Ice-T and Spike

Split Decision: Life Stories

Award-winning actor, rapper, and producer Ice-T unveils a compelling memoir of his early life robbing jewelry stores until he found fame and fortune—while a handful of bad choices sent his former crime partner down an incredibly different path.

Vicky, CC BY 2.0 https://creativecommons.org/licenses/by/2.0, via Wikimedia Commons

Ice-T and Spike

flowchart LR
A{Ice-T} --> |observed| B(Abandons criminal life)
A -.-> |missing counterfactual| C(Does one more heist)
C -.-> D[35 years in prison]
B --> E[Fame & Fortune]

classDef grey fill:#fff
class D,C grey

flowchart LR
A{Spike} -.-> |missing counterfactual| B(Abandons criminal life)
A --> |observed| C(Does one more heist)
C --> D[35 years in prison]
B -.-> E[Fame & Fortune]
classDef grey fill:#fff
class E,B grey

Ice-T and Spike

  • What would need to be true for us to draw a causal conclusion?
  • Can we really conclude that Spike’s life would have turned out exactly like Ice-T’s if he had made the exact same choices as Ice-T?

In practice

  • We could conduct an experiment where we randomize many individuals to leave criminal life (or not) and see how this impacts their outcomes on average
  • This randomized trial seems to present some ethical issues, perhaps we need to look to observational studies to help answer this question
  • We must rely on statistical techniques to help construct these unobservable counterfactuals

  1. Consistency
  2. Exchangeability
  3. Positivity

Consistency

  • We assume that the causal question you claim you are answering is consistent with the one you are actually answering with your analysis.
  • Mathematically: \(Y_{obs} = (X)Y(1) + (1-X)Y(0)\)
  • Well defined exposure
  • No interference

Well defined exposure

  • We assume that for each value of the exposure, there is no difference between subjects in the delivery of that exposure
  • Put another way, multiple versions of the treatment do not exist

No interference

  • We assume that the outcome (technically all potential outcomes, regardless of whether they are observed) for any subject does not depend on another subject’s exposure

Exchangeability

  • We assume that within levels of relevant variables (confounders), exposed and unexposed subjects have an equal likelihood of experiencing any outcome prior to exposure
  • i.e. the exposed and unexposed subjects are exchangeable
  • This assumption is sometimes referred to as no unmeasured confounding.

Positivity

  • We assume that within each level and combination of the study variables used to achieve exchangeability, there are exposed and unexposed subjects.
  • Said differently, each individual has some chance of experiencing every available exposure level.
  • Sometimes this is referred to as the probabilistic assumption.

The Target Trial Framework

Randomization

  • Purpose of Randomization: Solves key issues in causal inference
    • Consistency
    • Positivity
    • Does not address interference

Ideal vs Realizstic Randomized Trials

  • Ideal Randomized Trials
    • Achieve exchangeability
  • Realistic Randomized Trials
    • May violate exchangeability with non-adherence / dropout
Assumption Ideal Randomized Trial Realistic Randomized Trial Observational Study
Consistency (Well defined exposure) 😄 😄 🤷
Consistency (No interference) 🤷 🤷 🤷
Positivity 😄 😄 🤷
Exchangeability 😄 🤷 🤷

Study Protocol

  1. Eligibility criteria
  2. Exposure definition
  3. Assignment procedures
  4. Follow-up period
  5. Outcome definition
  6. Causal contrast of interest
  7. Analysis plan

Protcol elements mapped to assumptions

Assumption Eligibility Criteria Exposure Definition Assignment Procedures Follow-up Period Outcome Definition Causal contrast Analysis Plan
Consistency (Well-defined exposure) ✔️ ✔️ ✔️ ✔️
Consistency (No interference) ✔️ ✔️ ✔️ ✔️ ✔️
Positivity ✔️ ✔️ ✔️ ✔️ ✔️
Exchangeability ✔️ ✔️ ✔️ ✔️ ✔️ ✔️ ✔️

Mapped to diagraming causal claims

Target Trials

Target Trials

  • There are many reasons why randomization may not be possible
    • it might not be ethical to randomly assign people to a particular exposure
    • there may not be funding available
    • there might not be enough time to conduct a full trial

Target Trial

  • In these situations, we rely on observational data to help us answer causal questions by implementing a target trial
  • A target trial answers: What experiment would you design if you could?