Efficacy RCTs as survey twins


Surveys attempt to estimate a quantity of a finite population using a probability sample from that population. How people ended up in the population is somebody else’s problem – demographers, perhaps.

Survey participants are sampled at random from this finite population without replacement. Part a of the figure below illustrates. Green blocks denote people who are surveyed and from whom we collect data. Grey blocks denote people we have not surveyed; we would like to infer what their responses would have been, if they had they been surveyed too.

RCTs randomly assign participants to treatment or control conditions. This is illustrated in part b of the figure above: green cells denote treatment and purple cells denote control. There are no grey cells since we have gathered information from everyone in the finite population. But in a way, we haven’t really.

An alternative way to view efficacy RCTs that aim to estimate a sample average treatment effect (SATE) is as a kind of survey. This illustrated in part c. Now the grey cells return.

There is a finite population of people who present for a trial, often with little known about how they ended up in that population – not dissimilarly to the situation for a survey. (But who studies how they end up in a trial – trial demographers?)

Randomly assigning people to conditions generates two finite populations of theoretical twins, identical except for treatment assignment and the consequences thereafter. One theoretical twin receives treatment and the other receives control. But we only obtain the response from one of the twins, i.e., either the treatment or the control twin. (You could also think of these theoretical twins’ outcomes as potential outcomes.)

Looking individually at one of the two theoretical populations, the random assignment to conditions has generated a random sample from that population. We would like to know what the outcome would have been for everyone in the treatment condition, if everyone had been assigned treatment. Similarly for control. Instead, we have a pair of surveys that sample from these two populations.

Viewing the Table 1 fallacy through the survey twin lens

There is a common practice of testing for differences in covariates between treatment and control. This is the Table 1 fallacy (see also Dean Eckles’s take on whether it really is a fallacy). Let’s see how it can be explained using survey twins.

Firstly, we have a census of covariates for the whole finite population at baseline, so we know with perfect precision what the means are. Treatment and control groups are surveys of the same population, so clearly no statistical test is needed. The sample means in both groups are likely to be different from each other and from the finite population mean of both groups combined. No surprises there: we wouldn’t expect a survey mean to be identical to the population mean. That’s why we use confidence intervals or large samples so that the confidence intervals are very narrow.

What’s the correct analysis of an RCT?

It’s common to analyse RCT data using a linear regression model. The outcome variable is the endpoint, predictors are treatment group and covariates. This is also known as an ANCOVA. This analysis is easy to understand if the trial participants are a simple random sample from some infinite population. But this is not what we have in efficacy trials as modelled by survey twins above. If the total number of participants in the trial is 1000, then we have a finite population of 1000 in the treatment group and a finite population of 1000 in the control group – together, 2000. In total we have 1000 observations, though, split in some proportion between treatment and control.

Following through on this reasoning, it sounds like the correct analysis uses a stratified independent sampling design with two strata, coinciding with treatment and control groups. The strata populations are both 1000, and a finite population correction should be applied accordingly.

It’s a little more complicated, as I discovered in a paper by Reichardt and Gollob (1999), who independently derived results found by Neyman (1923/1990). Their results highlight a wrinkle in the argument when conducting a t-test on two groups for finite populations as described above. This has general implications for analyses with covariates too. The wrinkle is, the two theoretical populations are not independent of each other.

The authors derive the standard error of the mean difference between X and Y as

\(\displaystyle \sqrt{\frac{\sigma_X^2}{n_X} + \frac{\sigma_Y^2}{n_Y} – \left[ \frac{(\sigma_X – \sigma_Y)^2}{N} + \frac{2(1-\rho) \sigma_X \sigma_{Y}}{N} \right]}\),

where \(\sigma_X^2\) and \(\sigma_Y^2\) are the variances of the two groups, \(n_X\) and \(n_Y\) are the observed group sample sizes, and \(N\) is the total sample (the finite population) size. Finally, \(\rho\) is the unobservable correlation between treat and control outcomes for each participant – unobservable because we only get either the treatment outcome or control outcome for each participant and not both. The terms in square brackets correct for the finite population.

If the variances are equal (\(\sigma_X = \sigma_Y\)) and the correlation \(\rho = 1\), then the correction vanishes (glance back at numerators in the square brackets to see). This is great news if you are willing to assume that treatments have constant effects on all participants (an assumption known as unit-treatment additivity): the same regression analysis that you would use assuming a simple random sample from an infinite population applies.

If the variances are equal and the correlation is 0, then this is the same standard error as in the stratified independent sampling design with two strata described above. Or at least it was for the few examples I tried.

If the variances can be different and the correlation is one, then this is the same standard error as per Welch’s two-sample t-test.

So, which correlation should we use? Reichardt and Gollob (1999) suggest using the reliability of the outcome measure to calculate an upper bound on the correlation. More recently, Aronow, Green, and Lee (2014) proved a result that puts bounds on the correlation based on the observed marginal distribution of outcomes, and provide R code to copy and paste to calculate it. It’s interesting that a problem highlighted a century ago on something so basic – what standard error we should use for an RCT – is still being investigated now.

References

Aronow, P. M., Green, D. P., & Lee, D. K. K. (2014). Sharp bounds on the variance in randomized experiments. Annals of Statistics, 42, 850–871.

Neyman, J. (1923/1990). On the application of probability theory to agricultural experiments. Essay on principles. Section 9. Statistical Science, 5, 465-472.

Reichardt, C. S., & Gollob, H. F. (1999). Justifying the Use and Increasing the Power of a t Test for a Randomized Experiment With a Convenience Sample. Psychological Methods, 4, 117–128.