学术文献库

The clustered observational study (COS) design is the observational study counterpart to the clustered randomized trial. In a COS, a treatment is assigned to intact groups, and all units within the group are exposed to the treatment. However, the treatment is non-randomly assigned. COSs are common in both education and health services research. In education, treatments may be given to all students within some schools but withheld from all students in other schools. In health studies, treatments may be applied to clusters such as hospitals or groups of patients treated by the same physician. In this manuscript, we study the identification of causal effects in clustered observational study designs. We focus on the prospect of differential selection of units to clusters, which occurs when the units' cluster selections depend on the clusters' treatment assignments. Extant work on COSs has made an implicit assumption that rules out the presence of differential selection. We derive the identification results for designs with differential selection and that contexts with differential cluster selection require different adjustment sets than standard designs. We outline estimators for designs with and without differential selection. Using a series of simulations, we outline the magnitude of the bias that can occur with differential selection. We then present two empirical applications focusing on the likelihood of differential selection.