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A Guide to Regression Discontinuity Designs in Medical Applications

Matias D. Cattaneo, Luke Keele, Rocio Titiunik

arXiv 15 Feb 2023 · Statistics — Methodology · publishedStatistics in Medicine (2023) · 32 citations (OpenAlex)

arXiv:2302.07413 · PDF · DOI · OpenAlex · Extracted main text

Abstract

We present a practical guide for the analysis of regression discontinuity (RD) designs in biomedical contexts. We begin by introducing key concepts, assumptions, and estimands within both the continuity-based framework and the local randomization framework. We then discuss modern estimation and inference methods within both frameworks, including approaches for bandwidth or local neighborhood selection, optimal treatment effect point estimation, and robust bias-corrected inference methods for uncertainty quantification. We also overview empirical falsification tests that can be used to support key assumptions. Our discussion focuses on two particular features that are relevant in biomedical research: (i) fuzzy RD designs, which often arise when therapeutic treatments are based on clinical guidelines but patients with scores near the cutoff are treated contrary to the assignment rule; and (ii) RD designs with discrete scores, which are ubiquitous in biomedical applications. We illustrate our discussion with three empirical applications: the effect of CD4 guidelines for anti-retroviral therapy on retention of HIV patients in South Africa, the effect of genetic guidelines for chemotherapy on breast cancer recurrence in the United States, and the effects of age-based patient cost-sharing on healthcare utilization in Taiwan. We provide replication materials employing publicly available statistical software in Python, R and Stata, offering researchers all necessary tools to conduct an RD analysis.

Citation extraction

73
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Most heavily cited references

The works this paper leans on most, across its whole bibliography — not restricted to papers in our corpus. Ranked by composite intensity, which combines how often a work is mentioned, how many sections mention it, and how much of that falls in the main text rather than the appendix.

ReferenceIntensityMentionsSectionsMain text
1height .65ex depth -.6ex width 3em\ (2023) b)1.00095100%
2Cattaneo, M. D., Idrobo, N., and Titiunik, R (2020) a) self0.92844100%
3Cattaneo, M. D., and Titiunik, R (2022) Regression Discontinuity Designs self0.92844100%
4Cattaneo, M. D., Titiunik, R., and Vazquez-Bare, G (2017) Comparing Inference Approaches for RD Designs: A Reexamination of the Effect of Head Start on Child Mortality self0.87452100%
5Imbens, G. W., and Rubin, D. B (2015) Causal Inference in Statistics, Social, and Biomedical Sciences0.84333100%
6Rosenbaum, P. R (2010) Design of Observational Studies0.84333100%
7Cattaneo, M. D., Frandsen, B., and Titiunik, R (2015) Randomization Inference in the Regression Discontinuity Design: An Application to Party Advantages in the U.S self0.81142100%
8Baiocchi, M., Cheng, J., and Small, D. S (2014) Instrumental variable methods for causal inference0.73732100%
9Bor, J., Fox, M. P., Rosen, S., Venkataramani, A., Tanser, F., Pilla… (2017) Treatment eligibility and retention in clinical HIV care: A regression discontinuity study in South Africa0.73732100%
10height .65ex depth -.6ex width 3em\ (2021) Extrapolating Treatment Effects in Multi-Cutoff Regression Discontinuity Designs0.73732100%

Showing the top 10 of 73 scored citations.

Cited by, within the corpus

arXiv econ.EM papers that cite this one, ranked by how heavily they lean on it.

Citing paperIntensityMentionsSections
1Covariate Adjustment in Regression Discontinuity Designs0.64422
2A Practical Introduction to Regression Discontinuity Designs: Extensions0.40511
3Kernel Choice Matters for Local Polynomial Density Estimators at Boundaries0.40511
4The Regression Discontinuity Design in Medical Science0.40511
5The moment is here: a generalized class of estimators for fuzzy regression discontinuity designs0.40511