Fig. 6: Causal diagrams of target trial specification and emulation. | Nature Communications

Fig. 6: Causal diagrams of target trial specification and emulation.

From: Effectiveness of treat-to-target cholesterol-lowering interventions on cardiovascular disease and all-cause mortality risk in the community-dwelling population: a target trial emulation

Fig. 6

Causal graphs illustrate the effects of the treat-to-target cholesterol-lowering interventions (\(A\)) on cardiovascular disease, all-cause mortality, and atherosclerotic cardiovascular disease (\(Y\)) in the presence of competing events (\(C\)) using the sequentially randomized trial (the upper panel, i.e., target trial specification, a in which the intervention strategy \({A}_{k}\) only depends on prior cardiovascular risk profiles (\({L}_{k}\)), cholesterol levels and intervention history (\({A}_{k-1}\)) at each time \(k(k={{\mathrm{0,1}}},\ldots,28)\) and the hypothetical pragmatic trial (the bottom panel, i.e., target trial emulation, b in which \({A}_{k}\) depends on prior \({L}_{k}\), \({A}_{k-1}\), and the potential unmeasured confounders \({U}_{k}\). \({C}_{k-1}\) and \({Y}_{k}\) indicate the competing events at time interval \(k-1\) and the outcome of interest at time interval \(k\), respectively.

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