Vector-based kernel weighting: A simple estimator for improving precision and bias of average treatment effects in multiple treatment settings

Road safety evaluation with multiple treatments: A comparison of methods based on simulations

This paper focuses on ex-post road safety evaluation with multiple treatments. The potential outcome framework for causal inference is introduced to formalize the causal estimands of interest. Various estimation methods are compared via performing simulation experiments based on semi-synthetic data constructed from a London 20 mph zones dataset. The methods under evaluation include regressions, propensity score (PS) based methods, and a machine learning-based method termed generalized random forests (GRF). Both PS-based methods and GRF show higher flexibility with respect to functional specifications of outcome models. Moreover, GRF shows great superiority in the cases where road safety treatments are assigned following specific criteria and/or where there are heterogeneous treatment effects. Considering the ex-post evaluation of combined effects of multiple treatments has significant practical value, the potential outcome framework and the estimation methods presented in this paper are highly recommended for road safety studies.

Treatment of supraglottic squamous cell carcinoma with advanced technologies: observational prospective evaluation of oncological outcomes, functional outcomes, quality of life and cost-effectiveness (SUPRA-QoL)

BACKGROUND

Over the past decade, therapeutic options in head and neck supraglottic squamous cell carcinoma have constantly evolved. The classical total laryngectomy has been partially replaced by alternative organ- and function-sparing techniques with the same prognosis but less morbidity, such as Radiotherapy, Transoral Laser Microsurgery (TLM) and Trans-Oral Robotic Surgery (TORS). Up to now, a prospective comparison of these innovant techniques has not been conducted.

METHODS/DESIGN

We will conduct an original international multicentric prospective nonrandomized clinical trial to compare the efficacy between these treatments (Arm 1: Radiotherapy ± chemotherapy; Arm 2: TLM and Arm 3: TORS) with 4 classes of outcomes: quality of life (QoL), oncological outcomes, functional outcomes and economic resources. The population will include cT1-T2 /cN0-N1/M0 supraglottic squamous cell carcinoma. The primary outcome is a Clinical Dysphagia QoL evaluation assessed by the MD Anderson Dysphagia questionnaire. Secondary outcomes include others QoL evaluation, oncological and functional measures and cost parameters. The sample size needs to reach 36 patients per arm (total 108).

DISCUSSION

In the current literature, no prospective head-to-head trials are available to compare objectively these different treatments. With the increase of highly efficient treatments and the increase of oncological survival, it is imperative also to develop management strategies that optimize QoL and functional results. We will conduct this innovate prospective trial in order to obtain objective data in these two main issues.

TRIAL REGISTRATION

NCT05611515 posted on 10/11/2022 (clinicaltrial.fgov).