1. Lorraine Dearden Director of ADMIN Node Institute of Education Email: l.dearden@ioe.ac.uk

2. Introduction Give you a whirlwind tour of the economic approach to evaluation Can’t go into too much technical detail Excellent new review article by Blundell and Costa Dias (forthcoming Journal of Human Resources) – borrow heavily from their exposition But hope I get the essential ideas across so that you can judge which (if any) of the approaches may be useful Along the way give some of my initial thoughts on how different approaches may be used

3. The Evaluation Problem Question which we want to answer is What is the effect of some treatment (D i =1) on some outcome of interest (Y 1i ) compared to the outcome (Y 0i ) if the treatment had taken place (D i =0) Don’t observe the counterfactual Fine if treatment is randomly assigned, but in a lot of economic and epidemiological settings this is not the case The economic approach to evaluation involves methods that try and get around this selection problem

4. Selection Problem Selection bias: is caused by characteristics (observed (Z) and unobserved (v)) that affect both the decision to participate in the program and its outcomes If participants are systematically different from non-participants with respect to such characteristics, then the outcome observed for non-participants does not represent a good approximation to the counterfactual for participants

5. Economic Evaluation Methods Constructing the counterfactual in a convincing way is the key requirement Six distinct, but related approaches, attempting to deal with potential selection bias: Social experiment methods Natural experiments Matching methods Instrumental variable methods (not going to discuss) Discontinuity design methods Control function methods (not going to discuss)

6. Assignment to treatment Selection into treatment at time k is assumed to be made on the basis of an index function D* D* ik = Z ik c + v ik where c is the vector of coefficients and v ik the unobservable term The treatment status is then defined as D it = 1 if D* ik > 0 and t > k D it = 0 otherwise

7. What are we trying to measure? Express average parameters at time t>k at a particular value of Z ik = z as: Average treatment (ATE) for population (if individual assigned at random to treatment)  ATE (z) = E(  i | Z ik = z ) Average treatment effect on the treated (ATT)  ATT (z) = E(  i | Z ik = z, D it = 1 )= E(  i | Z ik = z, v ik >-zc) Average treatment effect on the non-treated (ATNT)  ATNT (z) = E(  i | Z ik = z, D it = 0 )= E(  i | Z ik = z, v ik <-zc) All these parameters identical if homogeneous treatment effects

8. Outcome equation The potential outcome for individual i at time t is given by (ignoring other covariates (X) that impact on Y): Y 1it =  +  i + u it if D it = 1 Y 0it =  + u it if D it = 0 Hence we can write: Y 1it =  +  i D it + u it Collecting unobserved heterogeneity terms together: Where is the ATE. Non-random selection occurs if e is correlated with D.

9. What does this mean? This implies e is either correlated with the regressors determining assignment, Z and/or correlated with the unobservable component in the selection equation (v) Consequently there are 2 forms of selection Selection on the observables Selection on the unobservables If homogeneous treatment effect, selection bias only occurs if D correlated with u whereas if heterogeneous treatment effect could also arise if D correlated with idiosyncratic gain from treatment Different estimators use different assumptions about assignment to identify the impact of the treatment

10. Social Experiment Closest to the theory free method of a clinical trial Relies on the availability of a random assignment rule The assumptions required are: R1:E[u i |D i =1]= E[u i |D i =0]=E[u i ] R2: E[  i |D i =1]= E[  i |D i =0]=E[  i ] If conditions hold, can identify the average effect in the experimental population using OLS (ATE)

11. Natural Experiments: Difference in Difference (DID) Estimator DID approach uses a natural experiment to mimic the randomisation of a social experiment Natural experiment – some naturally occuring event which creates a policy shift for one group and not another It may be a change in health policy in one jurisdiction but not another Or may refer to the eligibility of a certain group to a change in health policy for which a similar group is ineligible The difference in outcomes between the two groups before and after the policy change gives the estimate of the policy impact Require longitudinal data or repeated cross section data (where samples are drawn from the same population) before and after the intervention

12. DID Estimator Rewrite the outcome equation as: Y 1it =  +  i D it + u it =  +  i D it +  i +  t +  it i.e. u is decomposed into three terms: an unobserved fixed effect, an aggregate macro (time) shock and an idiosyncratic transitory shock The main assumption underlying DID is that selection into treatment is independent of the transitory shock: DID: E(u it | D it )=E(  i | D it )+  it that is R1 holds in first differences

13. DID estimator Measures ATT Doesn’t rule out selection on unobservables as long as fixed DID estimator is just first difference estimator commonly used with panel data in presence of fixed effects Problems if selection on idiosyncratic temporary shock, not common macro effect, compositional changes over time (repeated cross –sections) But may have applications, for instance postcode lottery with health services, abolition/introduction of health program or service affecting health for a sub- group of the population

14. Matching Methods Assumes all selection is based on observables characteristics/matching variables (X) that you have in your data OLS is a form of matching and will give you the ATT=ATE=ATNT if the X (i) are unaffected by the treatment (ii) contain all the variables that influence both the participation decision and the outcome of interest (iii) there is common support (all values of X are observed amongst treated and non-treated) Can use more flexible regression methods so if the effect of X’s is heterogeneous (testable) then ATT  ATNT  ATE

15. Propensity Score Matching Regression approaches are a form of matching approach Propensity score matching is another matching approach Shares a number of assumptions with regression based approaches A lot more flexible but also much more computationally expensive

16. Assumptions Matching is based on the following assumption M1: Conditional Independence Assumption (CIA) – condition on the set of observables X, the non-treated outcomes are independent of the participation status i.e. Assumption M1 implies a conditional version of R1 E[u i |D i, X i ]= E[u i | X i ] Slightly stronger assumption needed to get ATE Don’t need an equivalent of R2 to identify ATT as selection on the unobservable gains is accommodated by matching but do need one more assumption – that each treated observation can be reproduced amongst the non-treated

17. Common Support M2: All treated individuals have a counterpart on the non-treated population any anyone constitutes a possible participant So S the common support for X is the part of the distribution of X represented in the two groups All individuals in the treatment group for whom there is not common support are excluded from the matching estimate

18. Matching Involves selecting from the non-treated pool a control group in which the distribution of observed variables is as similar as possible to the distribution in the treated group (by coming up with a set of weights for the control group to make it look like the treatment group) There are a number of ways of doing this but they almost always involve calculating the propensity score p i (x)  Pr{D=1|X=x} Drop any individuals in treatment group who have propensity score greater than maximum in control group (to ensure common support)

19. The propensity score The propensity score is the probability of being in the treatment group given you have characteristics X=x How do you do this? Use parametric methods (e.g. logit or probit) and estimate the probability of a person being in the treatment group for all individuals in the treatment and non-treatment groups Rather than matching on the basis of ALL X’s can match on basis of this propensity score (Rosenbaum and Rubin (1983))

20. How do we match? All matching methods come up with a way of reweighting the control group ATT is the difference in the mean outcome in the two groups (appropriately weighted) Nearest neighbour matching each person in the treatment group choose individual(s) with the closest propensity score to them can do this with (most common) or without replacement not very efficient as discarding a lot of information about the control group

21. Kernel based matching each person in the treatment group is matched to a weighted sum of individuals who have similar propensity scores with greatest weight being given to people with closer scores Some kernel based matching use ALL people in non- treated group (e.g. Gaussian kernel) whereas others only use people within a certain probability user- specified bandwidth (e.g. Epanechnikov ) Choice of bandwidth involves a trade-off of bias with precision

22. Other methods Radius matching Caliper matching Mahalanobis matching Local linear regression matching Spline matching…..

23. Matching an option? Need very good data – otherwise highly likely selection on unobservables Common support – if some of treated cannot be matched then definition of estimated parameter becomes unclear Can also combine matching and DID methods - common support more problematic if using repeated cross-section Applications in Epidemiology? If have well designed pilot study with well chosen control groups and rich survey data then usually good approach(EMA evaluation in UK) Whether appropriate in other cases depends on questions and data availability

24. Regression Discontinuity Design Some deterministic rule means that some individuals below a threshold receive a treatment whereas those above to do not Look at differences in outcomes for those just below and just above the threshold to look at impact of treatment Like randomised control trial but only for a very specific group of individuals (UNLESS effect is constant across all participants – untestable)

25. Example of RDD Medical treatment given on basis of diagnostic test: compare impact of treatment for those just above and just below threshold Date of birth and when you start school – children born on 31 August start school one year earlier than children born on 1 September – can look at whether better to start school at age 4 or 5 in neighbourhood of discontinuity

27. Idea The RDD uses the discontinuous dependence of D on z at z*. The variable z is an observable variable which can also have an independent effect on the outcome of interest not just through its affect on D (unlike with the IV approach) The RDD approach relies on continuity assumptions namely: DD1: E(  i  |z) as a function of z is continuous at z=z* DD2: E(  i |z) as a function of z is continuous at z=z* DD3: The participation decision, D, is independent from the participation gain  i, in the neighbourhood of z*

28. What potential RDD? Major drawback of discontinuity design is its dependence on discontinuous changes in odds of participation dictated by the design of the policy Means can only look at impact of policy at a certain margin dictated by the discontinuity – generalisability much more difficult without strong assumptions.... If rule can be manipulated and/or if it changes behaviour then finding might be spurious – new diagnostic tests question a lot of early RDD findings See Lee|Lemieux NBER methodological paper

29. IV and Control Function Not going to discuss Control Function approach accounts for selection on unobservables by treating the endogeneity of D as an omitted variable problem Requires exclusion restrictions and distributional assumptions IV approach, like RDD requires finding a policy accident/exogenous event that means some people get a treatment whilst others don’t. It assumes that the accident/exogenous event only impacts on the outcome through its effect on D Untestable assumption

30. Conclusions Number of options when evaluating whether something effective and think economic approach to evaluation could be used in epidemiology Depends on nature of intervention, available data, question you want to answer Each methods has advantages and disadvantages and involves assumptions that may or may not be credible and all these factors have to be carefully assessed