何が知りたいのか？〜Estimand、傾向スコアマッチングは何を見てる？〜（医学統計学・疫学セミナー）

by Shuntaro Sato

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Կ͕஌Γ͍͔ͨʁ &TJNBOE܏޲είΞϚονϯά͸ԿΛݟͯΔʁ ࠤ౻ढ़ଠ࿕ ௕࡚େֶපӃྟচݚڀηϯλʔ TIVOUBSPTBUP!OBHBTBLJVBDKQ

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2 ϩʔυϚοϓ ݚڀͷ෼ྨ w ؔ࿈ͷ୳ࡧ w ҼՌਪ࿦ w ༧ଌ ޮՌ ൓ࣄ࣮ ؔ࿈ ަབྷ ਪఆ͍ͨ͠΋ͷʢ&TUJNBOEʣ ʢपลޮՌʣ ৚݅෇͖ޮՌ ଟมྔղੳ ඪ४Խ ܏޲είΞϚονϯά ٯ֬཰ॏΈ෇͚ "5& "55 ˞ղੳํ๏ͷखॱ͸આ໌͠·ͤΜ

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ݚڀͷ෼ྨ 3 %FTDSJQUJPO &YQMPSJOH BTTPDJBUJPOT 1SFEJDUJPO $BVTBMJOGFSFODF %JBHOPTUJD QFSGPSNBODF FWBMVBUJPO ʢهड़ʣ ʢؔ࿈ͷ୳ࡧʣ ʢ༧ଌʣ ʢҼՌਪ࿦ʣ ʢ਍அͷੑೳධՁʣ ม਺͸ͲΜͳ෼෍͔ʁ Ͳͷม਺͕Ξ΢τΧϜʹ ؔ࿈͢Δ͔ʁ Ξ΢τΧϜΛ༧ଌ͢Δ ॲஔ͕Ξ΢τΧϜʹ   Өڹ͢Δ͔ʁ ೚ҙͷධՁํ๏ͷ   ਍அੑೳ͸ʁ w )FSOÂO." )TV+ )FBMZ#"4FDPOE$IBODFUP(FU$BVTBM*OGFSFODF3JHIU"$MBTTJ fi DBUJPOPG%BUB4DJFODF5BTLT$IBODF+BO r w 7JUUJOHIP ff & (MJEEFO%7 4IJCPTLJ4$ .D$VMMPDI$&3FHSFTTJPONFUIPETJOCJPTUBUJTUJDTMJOFBS MPHJTUJD TVSWJWBM BOESFQFBUFENFBTVSFT NPEFMT4QSJOHFS4DJFODF#VTJOFTT.FEJB

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4 ଟมྔղੳ΍ ܏޲είΞϚονϯά΍ ٯ֬཰ॏΈ෇͚Ͱ ࠩʢൺʣͱ৴པ۠ؒΛࢉग़͠·ͨ͠ ަབྷΛ੍ޚ͢ΔͨΊʹ

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5 ͜ΕͰ׬ᘳʁ

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6 ҼՌਪ࿦ͯ͠ΔΜ͔ͩΒɺަབྷΛ੍ޚ͢Δͷ͸౰ͨΓલ Ұาઌ΁ʂ

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7 ຊ೔ͷϩʔυϚοϓ ݚڀͷ෼ྨ w ؔ࿈ͷ୳ࡧ w ҼՌਪ࿦ w ༧ଌ ޮՌ ൓ࣄ࣮ ؔ࿈ ަབྷ ਪఆ͍ͨ͠΋ͷʢ&TUJNBOEʣ ʢपลޮՌʣ ৚݅෇͖ޮՌ ଟมྔղੳ ඪ४Խ ܏޲είΞϚονϯά ٯ֬཰ॏΈ෇͚ "5& "55

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8 ·ͣ͸ޮՌͷఆ͔ٛΒ

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9 ޮՌͱؔ࿈ͷҧ͍ ݚڀର৅ूஂ ॲஔ͋Γ ॲஔͳ͠ ޮՌʢ& ff FDUʣ ؔ࿈ʢ"TTPDJBUJPOʣ ूஂશମ͕ॲஔ͋Γͷ৔߹ͱ   ॲஔͳ͠ͷ৔߹Λൺֱ ॲஔ͋Γͷूஂͱ   ॲஔͳ͠ͷूஂΛൺֱ )FSOÂO." 3PCJOT+. $BVTBM*OGFSFODF8IBU*G#PDB3BUPO$IBQNBO)BMM$3$'JHVSFΛվม

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10 ؔ࿈ΛޮՌʹ͚ۙͮΔ ޮՌʢ& ff FDUʣ ؔ࿈ʢ"TTPDJBUJPOʣ ूஂશମ͕ॲஔ͋Γͷ৔߹ͱ   ॲஔͳ͠ͷ৔߹Λൺֱ ॲஔ͋Γͷूஂͱ   ॲஔͳ͠ͷूஂΛൺֱ ͜ͷσʔλ͸ͳ͍ ͜ͷσʔλ͸͋Δ ؔ࿈ ޮՌ ݚڀσβΠϯ΍౷ܭղੳख๏Λ޻෉ͯ͠ܭࢉ͢Δ

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ޮՌΛܭࢉ͢ΔͨΊͷ৚݅ 11 w $POTJTUFODZ w &YDIBOHFBCJMJUZ w 1PTJUJWJUZ ˞͜͜Ͱͷ$POTJTUFODZ͸౷ܭֶͰͷ$POTJTUFODZʢҰகੑʣͱ͸ҟͳΓ·͢ ˞ͦΕͧΕͷ৚݅ͷৄ͍͠આ໌͸ׂѪ͠·͢ ަབྷΛͳ͘͢͜ͱ͕࠷ॏཁ

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12 ޮՌΛܭࢉ͢ΔͨΊʹ޻෉͢Δखஈ w ϥϯμϜԽൺֱࢼݧ w ࠩ෼ͷࠩ෼ w ճؼෆ࿈ଓσβΠϯ w ࣌ܥྻ෼அσβΠϯ ݚڀσβΠϯ w ʢҰൠతͳʣଟมྔղੳ w ඪ४Խ w ܏޲είΞΛ࢖ͬͨํ๏ w Ϛονϯά w ٯ֬཰ॏΈ෇͚ʢ*18ʣ w ૢ࡞ม਺๏ ౷ܭղੳख๏

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13 ղੳํ๏ʹ༏ྼ͸͋Δʁ ϩδεςΟοΫճؼ෼ੳΈ͍ͨͳ   ଟมྔղੳΑΓɺ   ܏޲είΞ࢖ͬͯٻΊͨޮՌͷํ͕ྑ͍ΜͰ͠ΐʁ w ʢҰൠతͳʣଟมྔղੳ w ඪ४Խ w ܏޲είΞΛ࢖ͬͨํ๏ w Ϛονϯά w ٯ֬཰ॏΈ෇͚ʢ*18ʣ w ૢ࡞ม਺๏

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14 ަབྷΛਖ਼੍͘͠ޚ͢Ε͹   Ͳͷղੳख๏Ͱ΋ޮՌ͸ਪఆͰ͖Δ ޮՌͷ छྨ͕ҧ͏

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15 Կ͕஌Γ͍ͨͷ͔ʁ &TUJNBOE

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16 ϩʔυϚοϓ ݚڀͷ෼ྨ w ؔ࿈ͷ୳ࡧ w ҼՌਪ࿦ w ༧ଌ ޮՌ ൓ࣄ࣮ ؔ࿈ ަབྷ ਪఆ͍ͨ͠΋ͷʢ&TUJNBOEʣ ʢपลޮՌʣ ৚݅෇͖ޮՌ ଟมྔղੳ ඪ४Խ ܏޲είΞϚονϯά ٯ֬཰ॏΈ෇͚ "5& "55

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17 ฏۉॲஔޮՌʢ"5&ʣ ݚڀର৅ूஂ ॲஔ͋Γ ॲஔͳ͠ "5& "WFSBHF5SFBUNFOU& ff FDU w ूஂશମ͕ॲஔ͋Γͷ৔߹ͱ   ूஂશମ͕ॲஔͳ͠ͷ৔߹Λൺֱ w ฏۉҼՌޮՌɿ   "$& "WFSBHF$BVTBM& ff FDU   ͱ΋ݺ͹ΕΔ

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18 ॲஔ܈ʹ͓͚ΔฏۉॲஔޮՌʢ"55ʣ ݚڀର৅ूஂ ॲஔ͋Γ ॲஔͳ͠ ॲஔ܈͕ॲஔ͋Γͷ৔߹ͱ   ॲஔ܈͕ॲஔͳ͠ͷ৔߹Λൺֱ "55 "WFSBHF5SFBUNFOU& ff FDUJOUIF5SFBUNFOUQPQVMBUJPO

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19 "5&ͷྫ ݚڀର৅ूஂ τγϦζϚϒ ΢ύμγνχϒ w ؔઅϦ΢ϚνͷױऀΛର৅ʹɺ   τγϦζϚϒͱ΢ύμγνχϒͷ༗ޮੑ ʢ%"4&43ʣͷҧ͍ʹڵຯ͕͋Δ w ݚڀऀ͸ɺؔઅϦ΢Ϛνױऀશମͷ༗ޮੑʹ ڵຯ͕͋Δ w τγϦζϚϒΛ౤༩ͨ͠܈͚ͩͰ͸ͳ͍ w ΢ύμγνχϒΛ౤༩ͨ͠܈͚ͩͰ͸ͳ͍

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20 "55ͷྫ ݚڀର৅ूஂ τγϦζϚϒ .59 w ؔઅϦ΢ϚνͷױऀΛର৅ʹɺ   τγϦζϚϒͷ҆શੑʢ෭࡞༻ͷൃੜʣʹڵ ຯ͕͋Δ w ൺֱରর͸ɺϝττϨΩαʔτʢ.59ʣ w ݚڀऀ͸ɺτγϦζϚϒ౤༩܈ͷ҆શੑͷΈ ʹڵຯ͕͋Δ w .59ͷ҆શੑʹ͸ڵຯͳ͍ w ؔઅϦ΢Ϛνͷױऀશମͷ҆શੑʹ͸ڵຯ ͳ͍

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21 ͜ͷݚڀͷ&TUJNBOE͸ʁ ॏ঱ͷഏԌױऀ ɹ࣏ྍ"͋Γ ࣏ྍ"ͳ͠ ॏ঱ͷഏԌױऀ ࣏ྍ"͋Γ ࣏ྍ"ͳ͠ "5& "55 ॏ঱ͷഏԌױऀʹɺ ࣏ྍ"Λ͢Δ͜ͱʹҙຯ͕͋Δʁ ॏ঱ͷഏԌͰ࣏ྍ"͞ΕΔױऀʹ   ࣏ྍ"͢Δ͜ͱʹҙຯ͕͋Δʁ 8FIZQPUIFTJ[FEUIBU"UIFSBQZDPVMECFF ff FDUJWFGPS   UIFUSFBUNFOUPGTFWFSFQOFVNPOJBQBUJFOUT

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22 ৚݅෇͖ޮՌʢ$POEJUJPOBMFGGFDUʣ ݚڀର৅ूஂ ॲஔ͋Γ ॲஔͳ͠ w ͋Δ૚ʹ͓͚ΔޮՌ w ೥ྸΛࡀະຬɺҎ্ͱ૚ʹ෼͚Δͱ   ࡀະຬͷ૚ʹ͓͚ΔޮՌ   ࡀҎ্ͷ૚ʹ͓͚ΔޮՌ ࡀҎ্ ࡀະຬ ࡀҎ্ ࡀະຬ

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23 ޮՌͱ౷ܭղੳํ๏ͷରԠʢجຊʣʢʣ "5& "55 $POEJUJPOBMF ff FDU ʢैདྷͷʣଟมྔղੳ ˓ ඪ४Խ ˓ 14Ϛονϯά ˓ *18 ˓

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24 γϯϓϧͳଟมྔղੳΛಡΈղ͘ Ξ΢τΧϜɿӡసதͷࢮ๢ ॲஔɿγʔτϕϧτண༻ ަབྷҼࢠɿੑผɺ٤Ԏ मਖ਼ϙΞιϯճؼ෼ੳ Ϟσϧɿॲஔੑผ٤Ԏྺ 33 $* 5SFBUNFOU UP 4FY .WT' UP 4NPLJOH UP փ৭෦෼͸ɺ   ަབྷҼࢠͷͨΊਪఆ஋ͷղऍ͸Ͱ͖ͳ͍ ˠ݁Ռʹग़͞ͳ͍ʢ5BCMFGBMMBDZʣ 8FTUSFJDI % (SFFOMBOE 4 5IFUBCMFGBMMBDZQSFTFOUJOHBOEJOUFSQSFUJOHDPOGPVOEFSBOENPEJ fi FSDPF ff i DJFOUT "NFSJDBO+PVSOBMPG&QJEFNJPMPHZ r ૊Έ߹Θͤ 33 $* .BMF 4NPLJOH UP .BMF /PTNPLJOH UP 'FNBMF 4NPLJOH UP 'FNBMF /PTNPLJOH UP આ໌ม਺ͷͲͷ૊Έ߹ΘͤͰ΋33͸ಉ͡ ͢΂ͯͷ૊Έ߹Θͤͷ33Λฏۉͯ͠΋33͸ಉ͡ γϯϓϧʹม਺Λ આ໌ม਺ʹՃ͑ͯ ͍͘Ϟσϧ $POEJUJPOBMF ff FDU"5&

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25 ޮՌम০ʢ&GGFDUNPEJ fi DBUJPOʣ Ξ΢τΧϜɿӡసதͷࢮ๢ ॲஔɿγʔτϕϧτண༻ ަབྷҼࢠɿੑผɺ٤Ԏ ޮՌम০ ੑผʹΑͬͯγʔτϕϧτண༻ͷޮՌ͕ҧ͏ͷͰ͸ʁ मਖ਼ϙΞιϯճؼ෼ੳ Ϟσϧɿॲஔੑผ٤Ԏྺॲஔºੑผ ੵ߲ ޮՌम০Λ͋ΒΘ͢ 33 $* 5SFBUNFOUJO.BMF UP 5SFBUNFOUJO'FNBMF UP આ໌ม਺ͷ૊Έ߹ΘͤͰ΋33͸ҧ͏ ͢΂ͯͷ૊Έ߹Θͤͷ33Λฏۉ͢Δͱ33͸ҧ͏ $POEJUJPOBMF ff FDU㱠"5&

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26 ޮՌͱ౷ܭղੳํ๏ͷରԠʢجຊʣʢʣ "5& "55 $POEJUJPOBMF ff FDU ʢैདྷͷʣଟมྔղੳ ޮՌम০ΛϞσϧʹ   ೖΕ͍ͯͳ͍ͱ͖͸˓ ˓ ඪ४Խ ˓ 14Ϛονϯά ˓ *18 ˓

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27 ޮՌͱ౷ܭղੳํ๏ͷରԠʢൃలʣ "5& "55 $POEJUJPOBMF ff FDU ଟมྔղੳ ޮՌम০ΛϞσϧʹ   ೖΕ͍ͯͳ͍ͱ͖͸ɺ˓ ˓ ඪ४Խ ˓ ˓ 14Ϛονϯά ˓ ˓ ˓ *18 ˓ ˓ ଞʹ΋͍Ζ͍ΖͳॏΈ෇͚ํ͕͋Δ

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28 ղੳํ๏ʹ༏ྼ͸͋Δʁ ϩδεςΟοΫճؼ෼ੳΈ͍ͨͳ   ଟมྔղੳΑΓɺ   ܏޲είΞ࢖ͬͯٻΊͨޮՌͷํ͕ྑ͍ΜͰ͠ΐʁ w ʢҰൠతͳʣଟมྔղੳ w ඪ४Խ w ܏޲είΞΛ࢖ͬͨํ๏ w Ϛονϯά w ٯ֬཰ॏΈ෇͚ʢ*18ʣ w ૢ࡞ม਺๏

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29 ަབྷΛ੍ޚ͢ΔͨΊʹɺ14Ϛονϯά͠·ͨ͠ʂ Ͱ͸ͳ͘ "55Λਪఆ͍͔ͨ͠Βɺ14Ϛονϯά͠·ͨ͠ʂ

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30 Λߟ͑Α͏ʂ &TUJNBOE

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31 ϩʔυϚοϓ ݚڀͷ෼ྨ w ؔ࿈ͷ୳ࡧ w ҼՌਪ࿦ w ༧ଌ ޮՌ ൓ࣄ࣮ ؔ࿈ ަབྷ ਪఆ͍ͨ͠΋ͷʢ&TUJNBOEʣ ʢपลޮՌʣ ৚݅෇͖ޮՌ ଟมྔղੳ ඪ४Խ ܏޲είΞϚονϯά ٯ֬཰ॏΈ෇͚ "5& "55