학술논문

Eliminating Ambiguous Treatment Effects Using Estimands.
Document Type
Article
Source
American Journal of Epidemiology. Jun2023, Vol. 192 Issue 6, p987-994. 8p.
Subject
*STATISTICS
*STUDY skills
*TREATMENT effectiveness
*RESEARCH ethics
*HYPOTHESIS
*DATA analysis
*MEDICAL research
*READING
*AUTHORSHIP
*EVALUATION
Language
ISSN
0002-9262
Abstract
Most reported treatment effects in medical research studies are ambiguously defined, which can lead to misinterpretation of study results. This is because most authors do not attempt to describe what the treatment effect represents, and instead require readers to deduce this based on the reported statistical methods. However, this approach is challenging, because many methods provide counterintuitive results. For example, some methods include data from all patients, yet the resulting treatment effect applies only to a subset of patients, whereas other methods will exclude certain patients while results will apply to everyone. Additionally, some analyses provide estimates pertaining to hypothetical settings in which patients never die or discontinue treatment. Herein we introduce estimands as a solution to the aforementioned problem. An estimand is a clear description of what the treatment effect represents, thus saving readers the necessity of trying to infer this from study methods and potentially getting it wrong. We provide examples of how estimands can remove ambiguity from reported treatment effects and describe their current use in practice. The crux of our argument is that readers should not have to infer what investigators are estimating; they should be told explicitly. [ABSTRACT FROM AUTHOR]