Adjusting for switches to multiple treatments: Should switches be handled separately or combined?

ABSTRACT: Treatment switching is common in randomised controlled trials (RCTs). Participants may switch onto a variety of different treatments, all of which may have different treatment effects. Adjustment analyses that target hypothetical estimands - estimating outcomes that would have been observed in the absence of treatment switching - have focused primarily on a single type of switch. In this study, we assess the performance of applications of inverse probability of censoring weights (IPCW) and two-stage estimation (TSE) which adjust for multiple switches by either (i) adjusting for each type of switching separately ('treatments separate') or (ii) adjusting for switches combined without differentiating between switched-to treatments ('treatments combined'). We simulate 48 scenarios in which RCT

SUBMITTER: Gorrod HB 

PROVIDER: S-EPMC11874486 | biostudies-literature | 2025 Feb

REPOSITORIES: biostudies-literature