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Researcher profile

Mark van der Laan

Mark van der Laan contributes to research discovery and scholarly infrastructure.

ResearcherAffiliation not importedOpen to collaborate
MethodologyApplicationsMachine Learningmath.STStatistics Theory

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Published work

6 published item(s)

preprint2026arXiv

Experiment-selector cross-validated targeted maximum likelihood estimator for hybrid RCT-external data studies

Augmenting a randomized controlled trial (RCT) with external data may increase power at the risk of introducing bias. To select and analyze the experiment (RCT alone or combined with external data) with the optimal bias-variance tradeoff, we develop a novel experiment-selector cross-validated targeted maximum likelihood estimator for randomized-external data studies (ES-CVTMLE). This estimator utilizes two estimates of bias to determine whether to integrate external data based on 1) a function of the difference in conditional mean outcome under control between the RCT and combined experiments and 2) an estimate of the average treatment effect on a negative control outcome (NCO). We define the asymptotic distribution of the ES-CVTMLE under varying magnitudes of bias and construct confidence intervals by Monte Carlo simulation. We evaluate ES-CVTMLE compared to three other data fusion estimators in simulations and demonstrate the ability of ES-CVTMLE to distinguish biased from unbiased external controls in a real data analysis of the effect of liraglutide on glycemic control from the LEADER trial. The ES-CVTMLE has the potential to improve power while providing relatively robust inference for future hybrid RCT-external data studies.

0 citations0 reviewsNo code linkedOpen access
preprint2026arXiv

Improving the Efficiency of Subgroup Analysis in Randomized Controlled Trials with TMLE

Subgroup analyses within randomized controlled trials are often underpowered due to limited sample sizes. We address this challenge by leveraging trial participants outside the subgroup of interest to augment estimation within the subgroup. Specifically, we study two Targeted Maximum Likelihood Estimators (TMLEs) that borrow information from non-subgroup participants within the same trial: a TMLE with pooled regression (TMLE-PR) and an Adaptive Targeted Maximum Likelihood Estimator (A-TMLE). Both estimators enable information sharing without relying on any external real-world data, thereby capitalizing on key strengths of the trial: most importantly, the protection against bias afforded by the randomized treatment, but also harmonized data collection, and consistent treatment and outcome definitions. The general strategy proposed here directly advances the priorities of key regulatory agencies, including the FDA, by improving the precision of subgroup-specific treatment effect estimates without introducing external sources of bias, thereby facilitating rigorous inference to support equitable labeling, access, and post-market evaluation. In a case study based on analysis of data from a cardiovascular outcome trial (LEADER, NCT01179048), we estimate the risk reduction of major adverse cardiac events (MACE) under liraglutide treatment among Black and Asian subgroups -- each comprising less than 10\% of the trial population -- using the proposed estimators that borrow information from the remainder of the trial. Using A-TMLE, in particular, we find estimated absolute MACE risk reductions of 1.6, 1.5, and 1.5 percentage points among Asian participants and 2.1, 2.0, and 2.1 percentage points among Black participants at 365, 540, and 730 days, respectively, with 95\% confidence intervals excluding the null at each time point.

0 citations0 reviewsNo code linkedOpen access
preprint2022arXiv

Evaluating and improving real-world evidence with Targeted Learning

Purpose: The Targeted Learning roadmap provides a systematic guide for generating and evaluating real-world evidence (RWE). From a regulatory perspective, RWE arises from diverse sources such as randomized controlled trials that make use of real-world data, observational studies, and other study designs. This paper illustrates a principled approach to assessing the validity and interpretability of RWE. Methods: We applied the roadmap to a published observational study of the dose-response association between ritodrine hydrochloride and pulmonary edema among women pregnant with twins in Japan. The goal was to identify barriers to causal effect estimation beyond unmeasured confounding reported by the study's authors, and to explore potential options for overcoming the barriers that robustify results. Results: Following the roadmap raised issues that led us to formulate alternative causal questions that produced more reliable, interpretable RWE. The process revealed a lack of information in the available data to identify a causal dose-response curve. However, under explicit assumptions the effect of treatment with any amount of ritodrine versus none, albeit a less ambitious parameter, can be estimated from data. Conclusion: Before RWE can be used in support of clinical and regulatory decision-making, its quality and reliability must be systematically evaluated. The TL roadmap prescribes how to carry out a thorough, transparent, and realistic assessment of RWE. We recommend this approach be a routine part of any decision-making process.

0 citations0 reviewsNo code linkedOpen access
preprint2021arXiv

Sequential causal inference in a single world of connected units

We consider adaptive designs for a trial involving N individuals that we follow along T time steps. We allow for the variables of one individual to depend on its past and on the past of other individuals. Our goal is to learn a mean outcome, averaged across the N individuals, that we would observe, if we started from some given initial state, and we carried out a given sequence of counterfactual interventions for $τ$ time steps. We show how to identify a statistical parameter that equals this mean counterfactual outcome, and how to perform inference for this parameter, while adaptively learning an oracle design defined as a parameter of the true data generating distribution. Oracle designs of interest include the design that maximizes the efficiency for a statistical parameter of interest, or designs that mix the optimal treatment rule with a certain exploration distribution. We also show how to design adaptive stopping rules for sequential hypothesis testing. This setting presents unique technical challenges. Unlike in usual statistical settings where the data consists of several independent observations, here, due to network and temporal dependence, the data reduces to one single observation with dependent components. In particular, this precludes the use of sample splitting techniques. We therefore had to develop a new equicontinuity result and guarantees for estimators fitted on dependent data. We were motivated to work on this problem by the following two questions. (1) In the context of a sequential adaptive trial with K treatment arms, how to design a procedure to identify in as few rounds as possible the treatment arm with best final outcome? (2) In the context of sequential randomized disease testing at the scale of a city, how to estimate and infer the value of an optimal testing and isolation strategy?

0 citations0 reviewsNo code linkedOpen access
preprint2021arXiv

Two-Stage TMLE to Reduce Bias and Improve Efficiency in Cluster Randomized Trials

Cluster randomized trials (CRTs) randomly assign an intervention to groups of individuals (e.g., clinics or communities) and measure outcomes on individuals in those groups. While offering many advantages, this experimental design introduces challenges that are only partially addressed by existing analytic approaches. First, outcomes are often missing for some individuals within clusters. Failing to appropriately adjust for differential outcome measurement can result in biased estimates and inference. Second, CRTs often randomize limited numbers of clusters, resulting in chance imbalances on baseline outcome predictors between arms. Failing to adaptively adjust for these imbalances and other predictive covariates can result in efficiency losses. To address these methodological gaps, we propose and evaluate a novel two-stage targeted minimum loss-based estimator (TMLE) to adjust for baseline covariates in a manner that optimizes precision, after controlling for baseline and post-baseline causes of missing outcomes. Finite sample simulations illustrate that our approach can nearly eliminate bias due to differential outcome measurement, while existing CRT estimators yield misleading results and inferences. Application to real data from the SEARCH community randomized trial demonstrates the gains in efficiency afforded through adaptive adjustment for baseline covariates, after controlling for missingness on individual-level outcomes.

0 citations0 reviewsNo code linkedOpen access
preprint2020arXiv

Nonparametric Bootstrap Inference for the Targeted Highly Adaptive LASSO Estimator

The Highly-Adaptive-LASSO Targeted Minimum Loss Estimator (HAL-TMLE) is an efficient plug-in estimator of a pathwise differentiable parameter in a statistical model that at minimal (and possibly only) assumes that the sectional variation norm of the true nuisance functional parameters (i.e., the relevant part of data distribution) are finite. It relies on an initial estimator (HAL-MLE) of the nuisance functional parameters by minimizing the empirical risk over the parameter space under the constraint that the sectional variation norm of the candidate functions are bounded by a constant, where this constant can be selected with cross-validation. In this article, we establish that the nonparametric bootstrap for the HAL-TMLE, fixing the value of the sectional variation norm at a value larger or equal than the cross-validation selector, provides a consistent method for estimating the normal limit distribution of the HAL-TMLE. In order to optimize the finite sample coverage of the nonparametric bootstrap confidence intervals, we propose a selection method for this sectional variation norm that is based on running the nonparametric bootstrap for all values of the sectional variation norm larger than the one selected by cross-validation, and subsequently determining a value at which the width of the resulting confidence intervals reaches a plateau. We demonstrate our method for 1) nonparametric estimation of the average treatment effect based on observing on each unit a covariate vector, binary treatment, and outcome, and for 2) nonparametric estimation of the integral of the square of the multivariate density of the data distribution. In addition, we also present simulation results for these two examples demonstrating the excellent finite sample coverage of bootstrap-based confidence intervals.

0 citations0 reviewsNo code linkedOpen access