IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/27293.html
   My bibliography  Save this paper

Statistical Decision Properties of Imprecise Trials Assessing COVID-19 Drugs

Author

Listed:
  • Charles F. Manski
  • Aleksey Tetenov

Abstract

As the COVID-19 pandemic progresses, researchers are reporting findings of randomized trials comparing standard care with care augmented by experimental drugs. The trials have small sample sizes, so estimates of treatment effects are imprecise. Seeing imprecision, clinicians reading research articles may find it difficult to decide when to treat patients with experimental drugs. Whatever decision criterion one uses, there is always some probability that random variation in trial outcomes will lead to prescribing sub-optimal treatments. A conventional practice when comparing standard care and an innovation is to choose the innovation only if the estimated treatment effect is positive and statistically significant. This practice defers to standard care as the status quo. To evaluate decision criteria, we use the concept of near optimality, which jointly considers the probability and magnitude of decision errors. An appealing decision criterion from this perspective is the empirical success rule, which chooses the treatment with the highest observed average patient outcome in the trial. Considering the design of recent and ongoing COVID-19 trials, we show that the empirical success rule yields treatment results that are much closer to optimal than those generated by prevailing decision criteria based on hypothesis tests.

Suggested Citation

  • Charles F. Manski & Aleksey Tetenov, 2020. "Statistical Decision Properties of Imprecise Trials Assessing COVID-19 Drugs," NBER Working Papers 27293, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:27293
    Note: EH TWP
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w27293.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Stoye, Jörg, 2009. "Minimax regret treatment choice with finite samples," Journal of Econometrics, Elsevier, vol. 151(1), pages 70-81, July.
    2. Charles F. Manski, 2004. "Statistical Treatment Rules for Heterogeneous Populations," Econometrica, Econometric Society, vol. 72(4), pages 1221-1246, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. John Mullahy, 2020. "Discovering Treatment Effectiveness via Median Treatment Effects—Applications to COVID-19 Clinical Trials," NBER Working Papers 27895, National Bureau of Economic Research, Inc.
    2. Domenico Depalo, 2021. "True COVID-19 mortality rates from administrative data," Journal of Population Economics, Springer;European Society for Population Economics, vol. 34(1), pages 253-274, January.
    3. John Mullahy, 2021. "Discovering treatment effectiveness via median treatment effects—Applications to COVID‐19 clinical trials," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 1050-1069, May.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Tetenov, Aleksey, 2012. "Statistical treatment choice based on asymmetric minimax regret criteria," Journal of Econometrics, Elsevier, vol. 166(1), pages 157-165.
    2. Manski, Charles F., 2023. "Probabilistic prediction for binary treatment choice: With focus on personalized medicine," Journal of Econometrics, Elsevier, vol. 234(2), pages 647-663.
    3. Firpo, Sergio & Galvao, Antonio F. & Kobus, Martyna & Parker, Thomas & Rosa-Dias, Pedro, 2020. "Loss Aversion and the Welfare Ranking of Policy Interventions," IZA Discussion Papers 13176, Institute of Labor Economics (IZA).
    4. Bhattacharya, Debopam & Dupas, Pascaline, 2012. "Inferring welfare maximizing treatment assignment under budget constraints," Journal of Econometrics, Elsevier, vol. 167(1), pages 168-196.
    5. Isaiah Andrews & Jesse M. Shapiro, 2021. "A Model of Scientific Communication," Econometrica, Econometric Society, vol. 89(5), pages 2117-2142, September.
    6. Aleksey Tetenov, 2016. "An economic theory of statistical testing," CeMMAP working papers 50/16, Institute for Fiscal Studies.
    7. Kock, Anders Bredahl & Preinerstorfer, David & Veliyev, Bezirgen, 2023. "Treatment recommendation with distributional targets," Journal of Econometrics, Elsevier, vol. 234(2), pages 624-646.
    8. Charles F. Manski & Aleksey Tetenov, 2014. "The Quantile Performance of Statistical Treatment Rules Using Hypothesis Tests to Allocate a Population to Two Treatments," CeMMAP working papers CWP44/14, Centre for Microdata Methods and Practice, Institute for Fiscal Studies.
    9. Azevedo, Eduardo M. & Mao, David & Montiel Olea, José Luis & Velez, Amilcar, 2023. "The A/B testing problem with Gaussian priors," Journal of Economic Theory, Elsevier, vol. 210(C).
    10. Shosei Sakaguchi, 2021. "Estimation of Optimal Dynamic Treatment Assignment Rules under Policy Constraints," Papers 2106.05031, arXiv.org, revised Aug 2024.
    11. Henrika Langen & Martin Huber, 2022. "How causal machine learning can leverage marketing strategies: Assessing and improving the performance of a coupon campaign," Papers 2204.10820, arXiv.org, revised Jun 2022.
    12. Aleksey Tetenov, 2016. "An economic theory of statistical testing," CeMMAP working papers CWP50/16, Centre for Microdata Methods and Practice, Institute for Fiscal Studies.
    13. Timothy B. Armstrong & Shu Shen, 2013. "Inference on Optimal Treatment Assignments," Cowles Foundation Discussion Papers 1927RR, Cowles Foundation for Research in Economics, Yale University, revised Apr 2015.
    14. Toru Kitagawa & Weining Wang & Mengshan Xu, 2022. "Policy Choice in Time Series by Empirical Welfare Maximization," Papers 2205.03970, arXiv.org, revised Jun 2023.
    15. Augustine Denteh & Helge Liebert, 2022. "Who Increases Emergency Department Use? New Insights from the Oregon Health Insurance Experiment," Papers 2201.07072, arXiv.org, revised Apr 2023.
    16. Yu-Chang Chen & Haitian Xie, 2022. "Personalized Subsidy Rules," Papers 2202.13545, arXiv.org, revised Mar 2022.
    17. Charles F. Manski & Aleksey Tetenov, 2015. "Clinical trial design enabling ε-optimal treatment rules," CeMMAP working papers 60/15, Institute for Fiscal Studies.
    18. Schlag, Karl H. & Zapechelnyuk, Andriy, 2021. "Robust sequential search," Theoretical Economics, Econometric Society, vol. 16(4), November.
    19. Thomas M. Russell, 2020. "Policy Transforms and Learning Optimal Policies," Papers 2012.11046, arXiv.org.
    20. Stoye, Jörg, 2012. "Minimax regret treatment choice with covariates or with limited validity of experiments," Journal of Econometrics, Elsevier, vol. 166(1), pages 138-156.

    More about this item

    JEL classification:

    • C44 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods: Special Topics - - - Operations Research; Statistical Decision Theory
    • I10 - Health, Education, and Welfare - - Health - - - General

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:27293. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.