Treatment effect bounds an application to Swan-Ganz catherization

We implement alternative bounding strategies to reanalyze data from the observational study by Connors et al. (1996) on the impact of Swan-Ganz catheterization on mortality outcomes. We implement both traditional bounds, which exploit access to an instrumental variable but impose no other assumption...

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Hauptverfasser: Bhattacharya, Jay (VerfasserIn), Shaikh, Azeem M. (VerfasserIn), Vytlacil, Edward 1972- (VerfasserIn)
Format: Buch
Sprache:English
Veröffentlicht: Cambridge, Mass. National Bureau of Economic Research 2005
Schriftenreihe:National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series 11263
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author Bhattacharya, Jay
Shaikh, Azeem M.
Vytlacil, Edward 1972-
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spelling Bhattacharya, Jay Verfasser (DE-588)124158250 aut
Treatment effect bounds an application to Swan-Ganz catherization Jay Bhattacharya ; Azeem M. Shaikh ; Edward Vytlacil
Cambridge, Mass. National Bureau of Economic Research 2005
44 S. graph. Darst.
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National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series 11263
We implement alternative bounding strategies to reanalyze data from the observational study by Connors et al. (1996) on the impact of Swan-Ganz catheterization on mortality outcomes. We implement both traditional bounds, which exploit access to an instrumental variable but impose no other assumptions (Manski, 1990), and the new bounds of Shaikh and Vytlacil (2004), which impose additional relatively mild nonparametric structural assumptions. Both of these approaches require an instrumental variable that shifts the probability of catheterization, but that does not alter mortality risks. We propose and justify using indicators of weekday admission as an instrumental variable in this context.<br>We find that, while the traditional instrumental variable bounds are almost entirely uninformative in our application, the Shaikh and Vytlacil (2004) bounds often produce a clear answer - catheterization reduces mortality at 7 days, and increases it at 30 days and after. Our findings suggest an explanation for the fact that many ICU doctors are deeply committed to the use of the Swan-Ganz catheter. Since most ICU patients leave the ICU well before 30 days after admission have elapsed, ICU doctors never observe the increase in mortality. They do, however, observe the decline in mortality at 7 days.
Cardiac catheterization
Hospital patients - Mortality
Krankenhaus / Sterblichkeit
Shaikh, Azeem M. Verfasser (DE-588)130506613 aut
Vytlacil, Edward 1972- Verfasser (DE-588)130529834 aut
Erscheint auch als Online-Ausgabe
National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series 11263 (DE-604)BV002801238 11263
http://papers.nber.org/papers/w11263.pdf kostenfrei Volltext
spellingShingle Bhattacharya, Jay
Shaikh, Azeem M.
Vytlacil, Edward 1972-
Treatment effect bounds an application to Swan-Ganz catherization
National Bureau of Economic Research <Cambridge, Mass.>: NBER working paper series
Cardiac catheterization
Hospital patients - Mortality
Krankenhaus / Sterblichkeit
title Treatment effect bounds an application to Swan-Ganz catherization
title_auth Treatment effect bounds an application to Swan-Ganz catherization
title_exact_search Treatment effect bounds an application to Swan-Ganz catherization
title_exact_search_txtP Treatment effect bounds an application to Swan-Ganz catherization
title_full Treatment effect bounds an application to Swan-Ganz catherization Jay Bhattacharya ; Azeem M. Shaikh ; Edward Vytlacil
title_fullStr Treatment effect bounds an application to Swan-Ganz catherization Jay Bhattacharya ; Azeem M. Shaikh ; Edward Vytlacil
title_full_unstemmed Treatment effect bounds an application to Swan-Ganz catherization Jay Bhattacharya ; Azeem M. Shaikh ; Edward Vytlacil
title_short Treatment effect bounds
title_sort treatment effect bounds an application to swan ganz catherization
title_sub an application to Swan-Ganz catherization
topic Cardiac catheterization
Hospital patients - Mortality
Krankenhaus / Sterblichkeit
topic_facet Cardiac catheterization
Hospital patients - Mortality
Krankenhaus / Sterblichkeit
url http://papers.nber.org/papers/w11263.pdf
volume_link (DE-604)BV002801238
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