Markets matter: a simulation study of the bias-variance trade-off in comparison group selection for difference-in-differences analysis.

Recent research reveals many pitfalls when selecting a comparison group for difference-in-differences analyses of observational data. Recommendations from this research, although important, can be difficult to apply to a complex, real-world evaluation. In this study we explore the potential value of...

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Publicado en:Health Services & Outcomes Research Methodology Vol. 25; no. 2; pp. 166 - 182
Autores principales: Forrow, Lauren Vollmer, Rotter, Jason, Blue, Laura, Vogler, Jake, Hatfield, Laura A.
Formato: equations & formulas research tables/charts Journal Article
Publicado: Springer Nature Jun2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2025
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10742-024-00332-7
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        atl: Markets matter: a simulation study of the bias-variance trade-off in comparison group selection for difference-in-differences analysis.
      aug:
        au:
          Forrow, Lauren Vollmer
          Rotter, Jason
          Blue, Laura
          Vogler, Jake
          Hatfield, Laura A.
        affil: https://ror.org/02403vr89 Mathematica, Inc., Cambridge, MA, USA
      sug:
        subj:
          Control Group
          Bias (Research)
          Models, Statistical
          Causality
          Study Design
          Primary Health Care United States
          Research Subject Recruitment
          Human
          Comparative Studies
          Funding Source
          United States
          Computer Simulation
          Medicare
          Fee for Service Plans
          Health Services Research
      ab: Recent research reveals many pitfalls when selecting a comparison group for difference-in-differences analyses of observational data. Recommendations from this research, although important, can be difficult to apply to a complex, real-world evaluation. In this study we explore the potential value of tailored simulation studies to inform comparison group designs for difference-in-differences analysis. We developed a simulation study mirroring the evaluation of Primary Care First (PCF), a primary care transformation model offered in select regions of the United States. We simulated primary care practices that volunteer for the intervention (intervention group) and two potential comparison groups: non-participating practices in PCF regions (within-market) and practices outside PCF regions (out-of-market). We assumed within-market comparison (i.e., non-participating) practices differ systematically from participating practices, whereas out-of-market practices are more similar to participating practices but experience different market-level outcome trends and shocks. We used Medicare fee-for-service spending data to quantify the likely magnitude of these forces. Using difference-in-differences analysis, we then estimated a hypothetical intervention's impact relative to each comparison group. We compared the mean squared error (MSE) of these impact estimates between the two comparison groups. The simulation revealed a bias-variance trade-off: the greater variation in impact estimates for the out-of-market comparison group generally led to higher MSE than the greater systematic bias of impact estimates for the within-market comparison group. More generally, a bespoke simulation study grounded in real data can quantify forces relevant to comparison group design and offer guidance to researchers seeking the best approach for their own evaluations.
      pubtype: Academic Journal
      doctype:
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        research
        tables/charts
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      ougenre: Article
    language: English
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