Evaluating Propensity Scores estimated in a Full Cohort versus
Subgroup-specific Propensity Scores on the Subgroup Treatment Effect.
Abstract
Often in observational studies the treatment effects within subgroups
are important. The question arises whether the overall propensity score
(PS) should be used to adjust for confounding and to estimate subgroup
treatment effects or whether PS should be recalculated within the
subgroups to estimate subgroup treatment effects. This paper addresses
this issue from the perspective of the PS differences and differences
for the within subgroup adjusted treatment effects. A specific real
world evidence oncology study is used to illustrate the findings. We
show that the propensity scores obtained from the within group model are
identical to the propensity scores obtained from the overall model with
the addition of the interaction effects of the subgroup variable with
the other confounders. This information being added to the overall
propensity score model is small. Thus, to analyze the treatment effect
within subgroups, either the overall propensity score or the within
subgroup propensity score will yield adjusted treatment effects which
are not substantively different. In addition, for both the within
subgroup PS and the overall PS, the treatment effects from the within
subgroups analysis are identical to the treatment effects form the
overall model and including propensity score by age interaction. We
conclude that it is not necessary to compute within subgroup propensity
scores nor to use within subgroup analyses to estimate the adjusted
within subgroup treatment effects. This is consistent with the primary
analysis which considers overall confounders and not how confounders may
differ within subgroups.