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Survival Mediation Analysis With The Death-Truncated Mediator: The Completeness Of The Survival Mediation Parameter, An-Shun Tai, Chun-An Tsai, Sheng-Hsuan Lin

Harvard University Biostatistics Working Paper Series

In medical research, the development of mediation analysis with a survival outcome has facilitated investigation into causal mechanisms. However, studies have not discussed the death-truncation problem for mediators, the problem being that conventional mediation parameters cannot be well-defined in the presence of a truncated mediator. In the present study, we systematically defined the completeness of causal effects to uncover the gap, in conventional causal definitions, between the survival and nonsurvival settings. We proposed three approaches to redefining the natural direct and indirect effects, which are generalized forms of the conventional causal effects for survival outcomes. Furthermore, we developed three statistical …