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2020_berkeley_txshift_withnotes.tex
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\documentclass{beamer}
\usetheme{metropolis}
% specifications for presenter mode
%\beamerdefaultoverlayspecification{<+->}
%\setbeamercovered{transparent}
\usepackage[english]{babel}
\usepackage[utf8x]{inputenc}
%\usepackage{coloremoji}
\usepackage{layout}
\usepackage{multirow}
\usepackage{array}
\usepackage{graphicx}
\graphicspath{ {figs/} }
\setbeameroption{show notes}
\setbeamertemplate{note page}[plain]
\usepackage{listings}
\usepackage{datetime}
\usepackage{url}
\usepackage{tcolorbox}
\usepackage{appendixnumberbeamer}
\usepackage{tikz}
\def\checkmark{\tikz\fill[scale=0.4](0,.35) -- (.25,0) -- (1,.7) -- (.25,.15) -- cycle;}
% math shorthand
\usepackage{bm}
\usepackage{amstext}
\usepackage{amsthm}
\usepackage{amsmath}
\usepackage{mathtools}
\newcommand{\R}{\mathbb{R}}
\newcommand{\D}{\mathcal{D}}
\newcommand{\E}{\mathbb{E}}
\newcommand{\I}{\mathbb{I}}
\newcommand{\pr}{\mathbb{P}}
\newcommand{\F}{\mathcal{F}}
\newcommand{\X}{\mathcal{X}}
\newcommand{\M}{\mathcal{M}}
\newcommand{\lik}{\mathcal{L}}
\newtheorem*{assumption*}{\assumptionnumber}
\providecommand{\assumptionnumber}{}
\makeatletter
\newenvironment{assumption}[2]
{%
\renewcommand{\assumptionnumber}{Assumption #1: $\mathcal{#2}$}%
\begin{assumption*}%
\protected@edef\@currentlabel{#1: $\mathcal{#2}$}%
}
{%
\end{assumption*}
}
\makeatother
\DeclarePairedDelimiterX{\infdivx}[2]{(}{)}{%
#1\;\delimsize\|\;#2%
}
\newcommand{\infdiv}{D\infdivx}
\DeclarePairedDelimiter{\norm}{\lVert}{\rVert}
\DeclareMathOperator*{\argmin}{arg\,min}
\DeclareMathOperator*{\argmax}{arg\,max}
% indepndence notation macro
\newcommand\indep{\protect\mathpalette{\protect\independenT}{\perp}}
\def\independenT#1#2{\mathrel{\rlap{$#1#2$}\mkern2mu{#1#2}}}
% Bibliography
\usepackage{natbib}
\bibpunct{(}{)}{,}{a}{}{;}
\usepackage{bibentry}
% title info
\title{\normalsize Evaluating the causal impacts of vaccine-induced immune
responses in two-phase vaccine efficacy trials}
\author{\href{https://nimahejazi.org}{Nima Hejazi}\\[-10pt]}
\institute{
\begin{figure}[!htb]
\centering
\begin{minipage}{.65\textwidth}
Graduate Group in Biostatistics, and \\
Center for Computational Biology, \\
University of California, Berkeley \\[6pt]
\includegraphics[scale=0.12]{twitter-icon.png}
\href{https://twitter.com/nshejazi}{nshejazi} \\
\includegraphics[scale=0.09]{github-icon.png}
\href{https://github.com/nhejazi}{nhejazi} \\
\includegraphics[scale=0.12]{homepage.png}
\href{https://nimahejazi.org}{nimahejazi.org} \\
with M.~van der Laan, H.~Janes, P.~Gilbert, D.~Benkeser \\
Causal Inference Seminar, UC Berkeley, Fall 2020
\end{minipage}%
\begin{minipage}{0.35\textwidth}
\centering
\includegraphics[height=0.80in,width=0.80in]{ucberkeleyseal_874_540.eps}
\end{minipage}
\end{figure}
}
\date{Wednesday, 04 November 2020}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
% Outline at beginning of each section
%\AtBeginSection[]
%{
%\begin{frame}<beamer>
%\frametitle{Outline}
%\tableofcontents[currentsection]
%\end{frame}
%}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{document}
\begin{frame}[noframenumbering]
\thispagestyle{empty}
\titlepage
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{The burden of HIV-1}
\begin{center}
\begin{itemize}
\itemsep10pt
\item The HIV-1 epidemic --- the facts:
\begin{itemize}
\item now in its fourth decade,
\item 2.5 million new infections occurring annually worldwide,
\item new infections outpace patients starting antiretroviral therapy.
\end{itemize}
\item \textit{Most efficacious} preventive vaccine: 31\% reduction rate.
\item \textbf{Question}: To what extent can HIV-1 vaccines be improved by
modulating immunogenic CD4+/CD8+ response profiles?
\end{itemize}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{HVTN 505 trial examined new antibody boost vaccines}
\begin{center}
\begin{itemize}
\itemsep10pt
\item HIV Vaccine Trials Network's (HVTN) 505 vaccine efficacy; randomized
controlled trial, $n = 2504$ \citep{hammer2013efficacy}.
\item \textbf{Question:} How would HIV-1 infection risk in week 28 have
changed had immunogenic response (due to vaccine) differed?
\item Immunogenic response profiles only available for second-stage sample of
$n = 189$ \citep{janes2017higher} due to cost limitations.
\item \underline{Two-phased sampling mechanism:} 100\% inclusion rate if
HIV-1 positive in week 28; based on matching otherwise.
\end{itemize}
\end{center}
\note{
\begin{itemize}
\itemsep10pt
\item Baseline covariates($L$): sex, age, BMI, behavioral HIV risk.
\item Intervention(s) ($A$): post-vaccination T-cell activity markers.
\item Outcome ($Y$): HIV-1 infection status at week 28 of tiral.
\item 12-color intracellular cytokine staining (ICS) assay.
\item Cryopreserved peripheral blood mononuclear cells were stimulated with
synthetic HIV-1 peptide pools.
\item All immune responses are assayed \textit{after} the endpoints of
interest (HIV-1 infection status) are collected.
\item \textbf{Conclusion:} Understanding which immune responses impact vaccine
efficacy helps develop more efficacious vaccines.
\item A vaccine effective at preventing HIV-1 acquisition would be a
cost-effective and durable approach to halting the worldwide epidemic.
\item Identifying vaccine-induced immune-response biomarkers that predict a
vaccine's ability to protect individuals from HIV-1 infection is a high
priority.
\item The study was halted on 22 April 2013 due to absence of vaccine
efficacy. There was no significant effect of the vaccine on the primary
infection endpoint of HIV-1 infection between week 28 and month 24.
\end{itemize}
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Two-phase sampling censors the complete data structure}
\begin{center}
\begin{itemize}
\itemsep10pt
\item Complete (\underline{unobserved}) data $X = (L, A, Y) \sim P_0^X \in
\mathcal{M}^X$, as per the full HVTN 505 trial cohort
\citep{hammer2013efficacy}:
\vspace{1em}
\begin{itemize}
\itemsep8pt
\item $L$ (baseline covariates): sex, age, BMI, behavioral HIV risk,
\item $A$ (exposure): immune response profile for CD4+ and CD8+,
\item $Y$ (outcome of interest): HIV-1 infection status at week 28.
\end{itemize}
\item Observed data $O = (C, C X) = (L, C, C A, Y)$; $C \in \{0,1\}$ is an
indicator for inclusion in the second-stage sample.
\end{itemize}
\end{center}
\note{
\begin{itemize}
\item $P_0^X$ --- true (unknown) distribution of the full data $X$,
\item $\mathcal{M}^X_{NP}$ --- nonparametric statistical model.
\end{itemize}
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{NPSEM with static interventions}
\begin{center}
\begin{itemize}
\itemsep10pt
\item Use a nonparametric structural equation model (NPSEM) to describe the
generation of $X$ \citep{pearl2009causality}, specifically
\begin{equation*}
L = f_L(U_L); A = f_A(L, U_A); Y = f_Y(A, L, U_Y)
\end{equation*}
\item Implies a model for the distribution of counterfactual random variables
generated by interventions on the process.
\item A \textit{static intervention} replaces $f_A$ with a specific value $a$
in its conditional support $A \mid L$.
\item This requires specifying a particular value of the exposure under which
to evaluate the outcome \textit{a priori}.
\end{itemize}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{NPSEM with stochastic interventions}
\begin{center}
\begin{itemize}
\itemsep10pt
\item \textit{Stochastic interventions} modify the value $A$ would naturally
assume by drawing from a modified exposure distribution.
\item Consider the post-intervention value $A^{\star} \sim G^{\star}(\cdot
\mid L)$; static interventions are a special case (degenerate distribution).
\item Such an intervention generates a counterfactual random variable
$Y_{G^{\star}} \coloneqq f_Y(A^{\star}, L, U_Y)$, with distribution
$P_0^{\delta}$, .
\item We aim to estimate $\psi_{0,\delta} \coloneqq \E_{P_0^{\delta}}
\{Y_{G^{\star}}\}$, the counterfactual mean under the post-intervention
exposure distribution $G^{\star}$.
\end{itemize}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Stochastic interventions for the causal effects of shifts}
\begin{center}
\begin{itemize}
\itemsep10pt
\item \cite{diaz2012population, diaz2018stochastic}'s \textit{stochastic}
interventions
\begin{equation*}\label{shift_intervention}
d(a, l) =
\begin{cases}
a + \delta, & a + \delta < u(l) \quad (\text{if plausible}) \\
a, & a + \delta \geq u(l) \quad (\text{otherwise})
\end{cases}
\end{equation*}
\item Our estimand is $\psi_{0, d} \coloneqq \E_{P_0^d}\{Y_{d(A,L)}\}$, mean
of $Y_{d(A, L)}$.
\item Statistical target parameter is
$\Psi(P_0^X) = \E_{P_0^X}{\overline{Q}(d(A, L), L)}$, counterfactual mean
of the \textit{shifted} outcome mechanism.
\item For HVTN 505, $\psi_{0,d}$ is the counterfactual risk of HIV-1
infection, had the observed value of the immune response been altered under
the rule $d(A,L)$ defining $G^{\star}(\cdot \mid L)$.
\end{itemize}
\end{center}
\note{
\begin{itemize}
\item Causal estimand: counterfactual mean of HIV-1 infection (risk) under a
\textit{shifted} immunogenic response distribution.
\end{itemize}
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{From the causal to the statistical target parameter}
\begin{center}
\begin{tcolorbox}
\begin{assumption}{1}{\textit{Consistency}}\label{consistency}
$Y^{d(a_i, l_i)}_i = Y_i$ in the event $A_i = d(a_i, l_i)$, for
$i = 1, \ldots, n$
\end{assumption}
\end{tcolorbox}
\begin{tcolorbox}
\begin{assumption}{2}{\textit{SUTVA}}\label{sutva}
$Y^{d(a_i, l_i)}_i$ does not depend on $d(a_j, l_j)$ for $i = 1,
\ldots, n$ and $j \neq i$, or lack of interference
\citep{rubin1978bayesian, rubin1980randomization}
\end{assumption}
\end{tcolorbox}
\begin{tcolorbox}
\begin{assumption}{3}{\textit{Strong ignorability}}\label{ignorability}
$A_i \indep Y^{d(a_i, l_i)}_i \mid L_i$, for $i = 1, \ldots, n$
\end{assumption}
\end{tcolorbox}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{From the causal to the statistical target parameter}
\begin{center}
\begin{tcolorbox}
\begin{assumption}{4}{\textit{Positivity (or overlap)}}\label{positivity}
$a_i \in \mathcal{A} \implies d(a_i, l_i) \in \mathcal{A}$ for all
$l \in \mathcal{L}$, where $\mathcal{A}$ denotes the support of $A$
conditional on $L = l_i$ for all $i = 1, \ldots n$
\end{assumption}
\end{tcolorbox}
\begin{itemize}
\itemsep4pt
\item This positivity assumption is not quite the same as that required for
categorical interventions.
\item In particular, we do not require that the intervention density place
mass across all strata defined by $L$.
\item Rather, we merely require the post-intervention quantity be seen in the
observed data for given $a_i \in \mathcal{A}$ and $l_i \in \mathcal{L}$.
\end{itemize}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Literature: \cite{diaz2012population}}
\begin{center}
\begin{itemize}
\itemsep10pt
\item \textit{Proposal:} Evaluate outcome under an altered
\textit{intervention distribution} --- e.g.,
$P_{\delta}(g_0)(A = a \mid L) = g_0(a - \delta(L) \mid L)$.
\item Identification conditions for a statistical parameter of the
counterfactual outcome $\psi_{0,d}$ under such an intervention.
\item Show that the causal quantity of interest $\E_0 \{Y_{d(A, L)}\}$ is
identified by a functional of the distribution of $X$:
\begin{align*}\label{eqn:identification2012}
\psi_{0,d} = \int_{\mathcal{L}} \int_{\mathcal{A}} &\E_{P_0^X} \{Y \mid
A = d(a, l), L = l\} \cdot \\ &q_{0, A}^X(a \mid L = l) \cdot
q_{0, L}^X(l) d\mu(a)d\nu(l)
\end{align*}
\item Provides a derivation based on the efficient influence function (EIF)
with respect to the nonparametric model $\mathcal{M}$.
\end{itemize}
\end{center}
\note{
\begin{itemize}
\item The identification result allows us to write down the causal quantity
of interest in terms of a functional of the observed data.
\item Key innovation: loosening standard assumptions through a change in
the observed intervention mechanism.
\item Problem: globally altering an intervention mechanism does not
necessarily respect individual characteristics.
\item The authors build IPW, A-IPW, and TML estimators, comparing the three
different approaches.
\item IMPORTANT: gives the g-computation formula for identification of this
estimator from the observed data structure.
\end{itemize}
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Flexible, efficient estimation}
\begin{center}
\begin{itemize}
\itemsep10pt
\item The efficient influence function (EIF) is:
\begin{equation*}
D(P_0^X)(x) = H(a, l)({y - \overline{Q}(a, l)}) +
\overline{Q}(d(a, l), l) - \Psi(P_0^X).
\end{equation*}
\item The one-step estimator corrects bias by adding the empirical mean of the
estimated EIF to the substitution estimator:
\begin{equation*}\label{tmle}
\Psi_n^{+} = \frac{1}{n} \sum_{i = 1}^n \overline{Q}_n(d(A_i, L_i),
L_i) + D_n(O_i).
\end{equation*}
\item The TML estimator is built by updating initial estimates of
$\overline{Q}_n$ via a (logistic) tilting model, yielding
\begin{equation*}\label{tmle}
\Psi_n^{\star} = \frac{1}{n} \sum_{i = 1}^n
\overline{Q}_n^{\star}(d(A_i, L_i), L_i).
\end{equation*}
\item Both estimators are CAN even when nuisance parameters are estimated via
flexible, machine learning techniques.
\end{itemize}
\end{center}
\note{
\begin{itemize}
\item Semiparametric-efficient estimation thru solving efficient influence
function estimating equation wrt the model $\M$.
\item The auxiliary covariate simplifies when the treatment is in the limits
(conditional on $W$) --- i.e., for $A_i \in (u(l) - \delta, u(l))$, then
we have $H(a,l) = \frac{g_0(a - \delta \mid l)}{g_0(a \mid l)} + 1$.
\item Need to explicitly remind the audience what $u(l)$ is again. It's only
appeared once at this point, and only been mentioned in passing.
\end{itemize}
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Augmented estimators for two-phase sampling designs}
\begin{center}
\begin{itemize}
\itemsep10pt
\item \cite{rose2011targeted2sd} introduce the IPCW-TMLE, to be used when
observed data is subject to two-phase sampling.
\item \textit{Initial proposal:} correct for two-phase sampling by using a
loss function with inverse probability of censoring weights:
\begin{equation*}
\lik(P_0^X)(O) = \frac{C}{\pi_0(Y, L)}\lik^F(P_0^X)(X)
\end{equation*}
\item When the sampling mechanism $\pi_0(Y,L)$ can be estimated by
a parametric form, this procedure yields an efficient estimator.
\item However, when machine learning is used (e.g., when $\pi_0(Y,L)$ is not
\textit{known by design}), this is insufficient.
\end{itemize}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Efficient estimation and multiple robustness}
\begin{center}
\begin{itemize}
\itemsep10pt
\item Then, the IPCW augmentation must be applied to the EIF:
\begin{align*}
D(P_0^X)(o) = &\frac{c}{\pi_0(y, l)} D^F(P_0^X)(x) - \left(1 -
\frac{c}{\pi_0(y, l)}\right) \cdot \\ &\E(D^F(P_0^X)(x) \mid
C = 1, Y = y, L = l),
\end{align*}
\begin{itemize}
\itemsep6pt
\item Expresses observed data EIF $D^F(P_0^X)(o)$ in terms of full data
EIF $D^F(P_0^X)(x)$; inclusion of second term ensures efficiency.
\item The expectation of the full data EIF $D^F(P_0^X)(x)$, taken only over
units selected by the sampling mechanism (i.e., $C = 1$).
\end{itemize}
\item A unique multiple robustness property --- combinations of
$(g_0(L), \overline{Q}_0(A,L)) \times (\pi_0(Y, L), \E(D^F(P^X_0)(x) \mid
C = 1, Y, L))$.
\end{itemize}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Fighting the HIV-1 epidemic with preventive vaccines}
%\vspace{-1.5em}
\begin{figure}[H]
\centering
\includegraphics[scale=0.19]{cd8_msm_tmle_summary}
\caption{
Analysis of HIV-1 risk as a function of CD8+ immunogenicity, using
\texttt{R} package \texttt{txshift}
(\url{https://github.com/nhejazi/txshift}.)
}
\end{figure}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Big picture takeaways}
\begin{center}
\begin{itemize}
\itemsep8pt
\item Vaccine efficacy evaluation helps to develop enhanced vaccines better
informed by biological properties of the target disease.
\item HIV-1 vaccines modulate immunogenic response profiles as part of their
mechanism for lowering HIV-1 infection risk.
\item \textit{Stochastic} interventions constitute a flexible framework for
considering \textbf{realistic} treatment/intervention policies.
\item Large-scale (vaccine) trials often use two-phase designs --- need to
(carefully!) accommodate for sampling complications.
\item We've developed robust, open source statistical software for assessing
stochastic interventions in observational studies.
\end{itemize}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Thank you!}
\includegraphics[scale=0.14]{homepage.png} \url{https://nimahejazi.org}
\vspace{2mm}
\includegraphics[scale=0.14]{twitter-icon.png}
\url{https://twitter.com/nshejazi}
\vspace{2mm}
\includegraphics[scale=0.11]{github-icon.png}
\url{https://github.com/nhejazi}
\vspace{2mm}
\includegraphics[scale=0.14]{paper-icon.png}
\url{https://doi.org/10.1111/biom.13375}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[standout]
At ``Warp Speed'' -- COVID-19 Vaccine Trials
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{COVID-19 Vaccine Development}
\begin{center}
\begin{itemize}
\itemsep10pt
\item \textit{Nucleic acid vaccines}: Moderna (mRNA), Pfizer (mRNA)
\item \textit{Viral-vectored vaccines}: AstraZeneca (chimpanzee adenovirus),
Janssen (human adenovirus)
\item \textit{Subunit vaccines}: NovaVax, Sanofi / GlaxoSmithKline
\item \textit{Weakened/inactivated vaccines}: Sinopharm, Sinovac
\end{itemize}
\end{center}
\note{
\begin{itemize}
\item Nucleic acid vaccines have never been approved before, but are quick
to manufacture.
\item Viral-vectored vaccines are also quick to manufacture but can develop
immunity against vector.
\item Subunit vaccines are a construct of several effective vaccines, but are
slower to manufacture and often require an adjuvant.
\end{itemize}
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{``Operation Warp Speed'' (OWS)}
\begin{center}
\begin{itemize}
\itemsep10pt
\item Do we have the time? Polio (7 years), Measles (9 years), Chickenpox (34
years), Mumps (4 years), HPV (15 years).
\item OWS: ``300M doses of safe, effective vaccine by 01 Jan.~2021''.
\item How? Typical process timeline (73 months) replaced by an
\textit{accelerated} process of 14 months.
\item COVID-19 Prevention Network (CoVPN):
\begin{itemize}
\item formed by NIAID to establish a unified clinical trial network
for evaluating vaccines and monoclonal antibodies.
\item Statisticians: primary trial design/analysis,
sequential efficacy monitoring, safety monitoring, immune correlates.
\end{itemize}
\end{itemize}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Immune Correlates of
Protection~\citep{plotkin2012nomenclature}}
\begin{center}
\begin{itemize}
\itemsep10pt
\item Correlate of Protection (CoP): immune marker statistically predictive
of vaccine efficacy, not necessarily mechanistic.
\item Mechanistic CoP (mCoP): immune marker that is mechanistically and
causally responsible for protection.
\item Nonmechanistic CoP (nCoP): immune marker that is predictive but not a
causal agent of protection.
\item A CoP is a \textit{candidate surrogate}
endpoint~\citep{prentice1989surrogate} --- primary
endpoint in future trials if reliably predictive.
\end{itemize}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Measuring Correlates: Two-Phase Designs}
\begin{center}
\begin{itemize}
\itemsep10pt
\item Running assays on $>30,000$ blood draws is timely, expensive, and,
as it turns out, statistically unnecessary.
\item Instead we measure immune responses via a case-cohort
design~\citep{prentice1986case}:
\begin{itemize}
\item a stratified random subcohort ($\approx 1600$ individuals)
\item all SARS-CoV-2 and COVID endpoints
\end{itemize}
\item Case-cohort designs are a special case of two-phase
sampling~\citep{breslow2003large,breslow2009improved}:
\begin{itemize}
\item Phase 1: measure baseline, vaccine, endpoint on everyone
\item Phase 2: given baseline, vaccine, endpoint, select members of
immune response subcohort with (possibly known) probability
\end{itemize}
\end{itemize}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Estimation in Two-Phase Designs}
\begin{center}
\begin{itemize}
\itemsep10pt
\item Observed data structure: $O = (L, A, Z, CM, Y, C)$
\begin{itemize}
\item $A \in \{0, 1\}$: randomized vaccination assignment
\item $Z$: post-vaccination confounder (e.g., unblinded risky behavior)
\item $M$: candidate mCoPs (causal mediators)
\item $Y$: symptomatic SARS-CoV-2 infection
\item $C \coloneqq f(Y, L)$: selection into second-phase sample
\end{itemize}
\item But what about $O = (L, A, Z, CM, \Delta, \widetilde{T}, C)$?
\begin{itemize}
\item $\widetilde{T} = min(T_F, T_C)$: possibly right-censored time
to symptomatic SARS-CoV-2 infection
\item $\Delta = \mathbb{I}(T_F < T_C)$: observed symptomatic SARS-CoV-2
infection
\item Can $C$ still be a function of $\widetilde{T}$?
\end{itemize}
\end{itemize}
\end{center}
\note{
\begin{itemize}
\item Goal: assess \textit{indirect} effect of vaccination through mCoPs.
\item Define/identify new mCoPs to be used as surrogate endpoints.
\item Could also have missing outcome in the binary endpoint case.
\end{itemize}
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Causal Mediation Analysis: Explanation and Mechanism}
\begin{center}
\begin{itemize}
\itemsep 10pt
\item Identification assumptions:
\begin{itemize}
\item A1: No unmeasured confounding of $\{A, Y\}$ relationship.
\item A2: No unmeasured confounding of $\{M, Y\}$ relationship.
\item A3: No unmeasured confounding of $\{A, M\}$ relationship.
\item A4: No $\{M, Y\}$ confounder affected by $A$, i.e., no $Z$.
\end{itemize}
\item \textit{Indirect} effects: thru pathways involving candidate mCoPs.
\begin{itemize}
\item Natural (in)direct effects~\citep{robins1992identifiability,
pearl2013direct}: binary $A$ and $M$, no $Z$, ``cross-world''
independence.
\item Stochastic (in)direct effects~\citep{diaz2020causal}:
continuous $A$ and $M$, no $Z$; no ``cross-world'' exclusion.
\item Interventional (in)direct effects~\citep{diaz2020nonparametric}:
binary $A$, continuous $M$, $Z$ ok, no ``cross-world'' exclusion.
\item Stochastic interventional (in)direct
effects~\citep{hejazi2020nonparametric}:
continuous $A$ and $M$, $Z$ ok, no ``cross-world'' exclusion.
\end{itemize}
\end{itemize}
\end{center}
\note{
\begin{itemize}
\item A1, A3 hold in randomized trials.
\item A2 may not hold: include all mutual $\{M, Y\}$ predictors, then perform
sensitivity analysis.
\item A4 usually doesn't hold: either measure $M$ right after $A$ or develop
more flexible effect definitions.
\item ``Cross-world'' independence: $Y(a, m) \perp M(a') \quad \forall m$;
un-testable in RCTs
\item Extensions for two-phase sampling???
\end{itemize}
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\appendix
\begin{frame}[standout]
Appendix
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Literature: \cite{haneuse2013estimation}}
\begin{center}
\begin{itemize}
\itemsep10pt
\item \textit{Proposal:} Characterization of stochastic interventions as
\textit{modified treatment policies} (MTPs).
\item Assumption of \textit{piecewise smooth invertibility} allows for the
intervention distribution of any MTP to be recovered:
\begin{equation*}
g_{0, \delta}(a \mid l) = \sum_{j = 1}^{J(l)} I_{\delta, j} \{h_j(a, l),
l\} g_0\{h_j(a, l) \mid l\} h^{'}_j(a,l)
\end{equation*}
\item Such intervention policies account for the natural value of the
intervention $A$ directly yet are interpretable as the imposition of an
altered intervention mechanism.
\item Identification conditions for assessing the parameter of interest under
such interventions appear technically complex (at first).
\end{itemize}
\end{center}
\note{
\begin{itemize}
\item Shifts of the form $d(A,L)$ are considerably more interesting since
these are realistic intervention policies.
\item Example: consider an individual with an extremely high immune response
but whose baseline covariates $L$ suggest we shift the response still
higher. Such a shift may not be biologically plausible (impossible, even)
but we cannot account for this if the shift is only a function of $L$.
\item The authors build IPW, outcome regression, and non-iterative doubly
robust estimators, as well as an approach based on MSMs.
\item Piecewise smooth invertibility: This assumption ensures that we can
use the change of variable formula when computing integrals over $A$ and
it is useful to study the estimators that we propose in this paper.
\end{itemize}
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Literature: \cite{young2014identification}}
\begin{center}
\begin{itemize}
\itemsep10pt
\item Establishes equivalence between g-formula when proposed intervention
depends on natural value and when it does not.
\item This equivalence leads to a sufficient positivity condition for
estimating the counterfactual mean under MTPs via the same statistical
functional studied in \cite{diaz2012population}.
\item Extends earlier identification results, providing a way to use the same
statistical functional to assess $\E Y_{d(A,L)}$ or $\E Y_{d(L)}$.
\item The authors also consider limits on implementing shifts $d(A,L)$, and
address working in a longitudinal setting.
\end{itemize}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Literature: \cite{diaz2018stochastic}}
\begin{center}
\begin{itemize}
\itemsep10pt
\item Builds on the original proposal, accomodating MTP-type shifts $d(A,L)$
proposed after their earlier work.
\item To protect against positivity violations, considers a specific shifting
mechanism:
\begin{equation*}\label{shift_intervention}
d(a, l) =
\begin{cases}
a + \delta, & a + \delta < u(l) \\
a, & \text{otherwise}
\end{cases}
\end{equation*}
\item Proposes an improved ``1-TMLE'' algorithm, with a single auxiliary
covariate for constructing the TML estimator.
\item Our (first) contribution: implementation of this algorithm.
\end{itemize}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Nonparametric conditional density estimation}
\begin{center}
\begin{itemize}
\itemsep8pt
\item To compute the auxiliary covariate $H(a,l)$, we need to estimate
conditional densities $g(A \mid L)$ and $g(A - \delta \mid L)$.
\item There is a rich literature on density estimation, we follow the approach
proposed in \cite{diaz2011super}.
\item To build a conditional density estimator, consider
\begin{equation*}
g_{n, \alpha}(a \mid L) = \frac{\pr (A \in [\alpha_{t-1}, \alpha_t)
\mid L)}{\alpha_t - \alpha_{t-1}},
\end{equation*}
for $\alpha_{t-1} \leq a < \alpha_t$.
\vspace{0.5em}
\begin{itemize}
\itemsep4pt
\item This is a classification problem, where we estimate the probability
that a value of $A$ falls in a bin $[\alpha_{t-1}, \alpha_t)$.
\item The choice of the tuning parameter $t$ corresponds roughly to the
choice of bandwidth in classical kernel density estimation.
\end{itemize}
\end{itemize}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Nonparametric conditional density estimation}
\begin{center}
\begin{itemize}
\itemsep8pt
\item \cite{diaz2011super} propose a re-formulation of this classification
approach as a set of hazard regressions.
\item To effectively employ this proposed re-formulation, consider
\begin{align*}
\pr (A \in [\alpha_{t-1}, \alpha_t) \mid L) =& \pr (A \in [\alpha_{t-1},
\alpha_t) \mid A \geq \alpha_{t-1}, L) \times \\ & \Pi_{j = 1}^{t -1}
\{1 - \pr (A \in [\alpha_{j-1}, \alpha_j) \mid A \geq \alpha_{j-1}, L) \}
\end{align*}
\vspace{0.25em}
\begin{itemize}
\itemsep4pt
\item The likelihood of this model may be expressed to correspond to the
likelihood of a binary variable in a data set expressed via a long-form
repeated measures structure.
\item Specifically, the observation of $X_i$ is repeated as many times as
intervals $[\alpha_{t-1}, \alpha_t)$ are before the interval to which
$A_i$ belongs, and the binary variables indicating $A_i \in
[\alpha_{t-1}, \alpha_t)$ are recorded.
\end{itemize}
\end{itemize}
\end{center}
\note{
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Density estimation with the Super Learner algorithm}
\begin{center}
\begin{itemize}
\itemsep10pt
\item To estimate $g(A \mid L$) and $g(A - \delta \mid L)$, use a pooled
hazard regression, spanning the support of $A$.
\item We rely on the Super Learner algorithm of \cite{vdl2007super} to build
an ensemble learner that optimally weights each of the proposed regressions,
using cross-validation (CV).
\item The Super Learner algorithm uses $V$-fold CV to train each proposed
regression model, weighting each by the inverse of its average risk across
all $V$ holdout sets.
\item By using a library of regression estimators, we invoke the result of
\cite{vdl2004asymptotic}, who prove this likelihood-based cross-validated
estimator to be asymptotically optimal.
\end{itemize}
\end{center}
\note{
\begin{itemize}
\item The auxiliary covariate simplifies when the treatment is in the limits
(conditional on $L$) --- i.e., for $A_i \in (u(l) - \delta, u(l))$, then we
have $H(a,l) = \frac{g_0(a - \delta \mid l)}{g_0(a \mid l)} + 1$.
\item Asymptotically optimal in the sense that it performs as well as the
oracle selector as the sample size increases.
\end{itemize}
}
\end{frame}
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\begin{frame}[c]{Key properties of TML estimators}
\begin{center}
\begin{itemize}
\itemsep10pt
\item \textbf{Asymptotic linearity:}
\begin{equation*}
\Psi(P_n^{\star}) - \Psi(P_0^X) = \frac{1}{n} \sum_{i = 1}^{n}
D(P_0^X)(X_i) + o_P\left(\frac{1}{\sqrt{n}}\right)
\end{equation*}
\item \textbf{Gaussian limiting distribution:}
\begin{equation*}
\sqrt{n}(\Psi(P_n^{\star}) - \Psi(P_0^X)) \to N(0, Var(D(P_0^X)(X)))
\end{equation*}
\item \textbf{Statistical inference:}
\begin{equation*}
\text{Wald-type confidence interval}: \Psi(P_n^{\star}) \pm z_{1 -
\frac{\alpha}{2}} \cdot \frac{\sigma_n}{\sqrt{n}},
\end{equation*}
where $\sigma_n^2$ is computed directly via
$\sigma_n^2 = \frac{1}{n} \sum_{i = 1}^{n} D^2(\cdot)(X_i)$.