Abstract

In a study comparing the effects of two treatments, the propensity score is the probability of assignment to one treatment conditional on a subject's measured baseline covariates. Propensity-score matching is increasingly being used to estimate the effects of exposures using observational data. In the most common implementation of propensity-score matching, pairs of treated and untreated subjects are formed whose propensity scores differ by at most a pre-specified amount (the caliper width). There has been a little research into the optimal caliper width. We conducted an extensive series of Monte Carlo simulations to determine the optimal caliper width for estimating differences in means (for continuous outcomes) and risk differences (for binary outcomes). When estimating differences in means or risk differences, we recommend that researchers match on the logit of the propensity score using calipers of width equal to 0.2 of the standard deviation of the logit of the propensity score. When at least some of the covariates were continuous, then either this value, or one close to it, minimized the mean square error of the resultant estimated treatment effect. It also eliminated at least 98% of the bias in the crude estimator, and it resulted in confidence intervals with approximately the correct coverage rates. Furthermore, the empirical type I error rate was approximately correct. When all of the covariates were binary, then the choice of caliper width had a much smaller impact on the performance of estimation of risk differences and differences in means. Copyright © 2010 John Wiley & Sons, Ltd.

Highlights

  • Observational studies are increasingly being used to estimate the effects of treatments and exposures on health outcomes

  • We examined the impact of caliper width on reduction in bias, mean squared error (MSE), coverage of confidence intervals, and type I error rates

  • We used Monte Carlo simulations to examine the relationship between the caliper width used for propensity-score matching and the performance of estimation of the risk differences and differences in means

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Summary

Introduction

Observational studies are increasingly being used to estimate the effects of treatments and exposures on health outcomes. Randomization ensures that, in expectation, the baseline characteristics of treated subjects do not differ systematically from those of untreated subjects. In observational studies, treated subjects often differ systematically from untreated subjects in both measured and unmeasured baseline characteristics. Statistical methods must be used to adjust for systematic differences between treated and untreated subjects when estimating the effects of treatment on outcomes using observational data. The propensity score is defined to be the probability of exposure to the treatment conditional on a subject’s observed baseline characteristics [1,2]. In propensity-score matching, matched sets of treated and untreated subjects with similar values of the propensity score are formed. The effect of treatment on outcomes is estimated in the matched sample consisting of all matched sets

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