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2017 ; 28
(2
): 258-265
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Interventional Effects for Mediation Analysis with Multiple Mediators
#MMPMID27922534
Vansteelandt S
; Daniel RM
Epidemiology
2017[Mar]; 28
(2
): 258-265
PMID27922534
show ga
The mediation formula for the identification of natural (in)direct effects has
facilitated mediation analyses that better respect the nature of the data, with
greater consideration of the need for confounding control. The default
assumptions on which it relies are strong, however. In particular, they are known
to be violated when confounders of the mediator-outcome association are affected
by the exposure. This complicates extensions of counterfactual-based mediation
analysis to settings that involve repeatedly measured mediators, or multiple
correlated mediators. VanderWeele, Vansteelandt, and Robins introduced so-called
interventional (in)direct effects. These can be identified under much weaker
conditions than natural (in)direct effects, but have the drawback of not adding
up to the total effect. In this article, we adapt their proposal to achieve an
exact decomposition of the total effect, and extend it to the multiple mediator
setting. Interestingly, the proposed effects capture the path-specific effects of
an exposure on an outcome that are mediated by distinct mediators, even when-as
often-the structural dependence between the multiple mediators is unknown, for
instance, when the direction of the causal effects between the mediators is
unknown, or there may be unmeasured common causes of the mediators.