Reflection on modern methods: constructing directed acyclic graphs (DAGs) with domain experts for health services research
File(s)dyac135.pdf (1.1 MB)
Published online version
Author(s)
Rodrigues, Daniela
Kreif, Noemi
Lawrence-Jones, Anna
Barahona, Mauricio
Mayer, Erik
Type
Journal Article
Abstract
Directed acyclic graphs (DAGs) are a useful tool to represent, in a graphical format, researchers’ assumptions about the causal structure among variables while providing a rationale for the choice of confounding variables to adjust for. With origins in the field of probabilistic graphical modelling, DAGs are yet to be widely adopted in applied health research, where causal assumptions are frequently made for the purpose of evaluating health services initiatives. In this context, there is still limited practical guidance on how to construct and use DAGs. Some progress has recently been made in terms of building DAGs based on studies from the literature, but an area that has received less attention is how to create DAGs from information provided by domain experts, an approach of particular importance when there is limited published information about the intervention under study. This approach offers the opportunity for findings to be more robust and relevant to patients, carers and the public, and more likely to inform policy and clinical practice. This article draws lessons from a stakeholder workshop involving patients, health care professionals, researchers, commissioners and representatives from industry, whose objective was to draw DAGs for a complex intervention—online consultation, i.e. written exchange between the patient and health care professional using an online system—in the context of the English National Health Service. We provide some initial, practical guidance to those interested in engaging with domain experts to develop DAGs.
Date Issued
2022-06-17
Date Acceptance
2022-06-07
Citation
International Journal of Epidemiology, 2022, 51
ISSN
0300-5771
Publisher
Oxford University Press
Journal / Book Title
International Journal of Epidemiology
Volume
51
Copyright Statement
© The Author(s) 2022. Published by Oxford University Press on behalf of the International Epidemiological Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
National Institute for Health Research
National Institute for Health Research
Imperial College Healthcare NHS Trust- BRC Funding
NHS North West London CCG
Engineering & Physical Science Research Council (EPSRC)
Nuffield Foundation
Identifier
https://academic.oup.com/ije/article/51/4/1339/6609840
Grant Number
RDB04
RDE07 79560
RDF03
RDF01
XXKSARAVANAKUMAR
EP/N014529/1
NUFF_IMP
Subjects
Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Causal inference
potential outcomes
directed acyclic graphs
policy evaluation
health services research
OBSERVATIONAL RESEARCH
SENSITIVITY-ANALYSIS
CAUSAL INFERENCE
KNOWLEDGE
Causal inference
directed acyclic graphs
health services research
policy evaluation
potential outcomes
Epidemiology
0104 Statistics
1117 Public Health and Health Services
Publication Status
Published online
Date Publish Online
2022-06-17