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Doubly robust estimators have gained popularity in the field of causal inference due to their ability to provide consistent point estimates when either an outcome or exposure model is correctly specified. However, for nonrandomized exposures the influence function based variance estimator frequently used with doubly robust estimators of the average causal effect is only consistent when both working models (i.e., outcome and exposure models) are correctly specified. Here, the empirical sandwich variance estimator and the nonparametric bootstrap are demonstrated to be doubly robust variance estimators. That is, they are expected to provide valid estimates of the variance leading to nominal confidence interval coverage when only one working model is correctly specified. Simulation studies illustrate the properties of the influence function based, empirical sandwich, and nonparametric bootstrap variance estimators in the setting where parametric working models are assumed. Estimators are applied to data from the Improving Pregnancy Outcomes with Progesterone (IPOP) study to estimate the effect of maternal anemia on birth weight among women with HIV., Comment: 32 pages, 14 figures, 13 tables

Despite considerable progress in maternal healthcare, maternal and perinatal deaths remain high in low-to-middle income countries. Fetal ultrasound is an important component of antenatal care, but shortage of adequately trained healthcare workers has limited its adoption. We developed and validated an artificial intelligence (AI) system that uses novice-acquired "blind sweep" ultrasound videos to estimate gestational age (GA) and fetal malpresentation. We further addressed obstacles that may be encountered in low-resourced settings. Using a simplified sweep protocol with real-time AI feedback on sweep quality, we have demonstrated the generalization of model performance to minimally trained novice ultrasound operators using low cost ultrasound devices with on-device AI integration. The GA model was non-inferior to standard fetal biometry estimates with as few as two sweeps, and the fetal malpresentation model had high AUC-ROCs across operators and devices. Our AI models have the potential to assist in upleveling the capabilities of lightly trained ultrasound operators in low resource settings.