Propensity Score Weighting for Causal Inference with Clustered Data

Abstract Propensity score weighting is a tool for causal inference to adjust for measured confounders in observational studies. In practice, data often present complex structures, such as clustering, which make propensity score modeling and estimation challenging. In addition, for clustered data, there may be unmeasured cluster-level covariates that are related to both the treatment assignment and outcome. When such unmeasured cluster-specific confounders exist and are omitted in the propensity score model, the subsequent propensity score adjustment may be biased. In this article, we propose a calibration technique for propensity score estimation under the latent ignorable treatment assignment mechanism, i. e., the treatment-outcome relationship is unconfounded given the observed covariates and the latent cluster-specific confounders. We impose novel balance constraints which imply exact balance of the observed confounders and the unobserved cluster-level confounders between the treatment groups. We show that the proposed calibrated propensity score weighting estimator is doubly robust in that it is consistent for the average treatment effect if either the propensity score model is correctly specified or the outcome follows a linear mixed effects model. Moreover, the proposed weighting method can be combined with sampling weights for an integrated solution to handle confounding and sampling designs for causal inference with clustered survey data. In simulation studies, we show that the proposed estimator is superior to other competitors. We estimate the effect of School Body Mass Index Screening on prevalence of overweight and obesity for elementary schools in Pennsylvania.