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Population-average mediation analysis for zero-inflated count outcomes

Authors :
Sims, Andrew
Long, D. Leann
Tiwari, Hemant K.
Cui, Jinhong
Long, Dustin M.
Brown, Todd M.
Smith, Melissa J.
Levitan, Emily B.
Publication Year :
2023

Abstract

Mediation analysis is an increasingly popular statistical method for explaining causal pathways to inform intervention. While methods have increased, there is still a dearth of robust mediation methods for count outcomes with excess zeroes. Current mediation methods addressing this issue are computationally intensive, biased, or challenging to interpret. To overcome these limitations, we propose a new mediation methodology for zero-inflated count outcomes using the marginalized zero-inflated Poisson (MZIP) model and the counterfactual approach to mediation. This novel work gives population-average mediation effects whose variance can be estimated rapidly via delta method. This methodology is extended to cases with exposure-mediator interactions. We apply this novel methodology to explore if diabetes diagnosis can explain BMI differences in healthcare utilization and test model performance via simulations comparing the proposed MZIP method to existing zero-inflated and Poisson methods. We find that our proposed method minimizes bias and computation time compared to alternative approaches while allowing for straight-forward interpretations.<br />Comment: 34 pages, 2 figures, 4 tables, 49 pages of Supplemental material, 2 supplemental figures

Subjects

Subjects :
Statistics - Methodology

Details

Database :
arXiv
Publication Type :
Report
Accession number :
edsarx.2308.06831
Document Type :
Working Paper