Surrogate-powered Causal Inference on Censored Outcomes

13589
""

Surrogate-powered Causal Inference on Censored Outcomes

Yaroslav Mukhin, Assistant Research Professor at Cornell University
Clinical trials with survival endpoints lose information when participants are censored before death is observed. We develop target-preserving estimators that use posttreatment disease history, such as recurrence or progression, to recover information lost to censoring for marginal survival and restricted mean survival effects. The difficulty is that the intermediate event is downstream of treatment: naive adjustment can change the causal estimand, and the useful information enters only through the observed coarsening. We derive observed-data influence functions with and without recurrence history and obtain an exact gain identity. The identity shows that efficiency improvement is driven by the censoring hazard, the split of the alive risk set into recurrence states, and the residual-survival separation between those states. In the no-covariate illness--death model, the Aalen--Johansen estimator realizes the recurrence-augmented efficient score after standardization to the marginal target. With covariates, correctly specified Cox--Breslow transition hazards provide a root-n plug-in benchmark, while a hazard-induced one-step estimator gives rate robustness and, under transition-law stability, canonical inference with flexible learners. A semi-synthetic metastatic breast cancer study calibrated from digitized progression-free survival and overall survival curves illustrates the gain identity. The framework applies broadly to censored time-to-event studies with informative intermediate histories. 
Joint work with Tereza Oprea, Arielle Anderer, Christina Yu, Jelena Bradic.
 
Yaroslav Mukhin is an Assistant Research Professor at Cornell University. Previously, he taught statistics in the Department of Economics at Dartmouth College and MIT IDSS, and completed a PhD in Economics and Statistics at MIT.