Marginal structural models: Much ado about (almost) nothing

Eyal Shahar, Doron J. Shahar

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


Marginal structural models were developed to account for a so-called time-dependent confounder and to estimate the presumed effect of 'treatment regime' (treatment over time). We present a set of causal axioms, according to which the problem of time-dependent confounding does not exist, and 'treatment regime' affects nothing. Per our axiomatization, marginal structural models do not introduce a new idea of deconfounding, but simply estimate a weighted average of effects. Whenever a weighted average and the weighting scheme can both be rationalized, the models are acceptable. Whenever a weighted average does not estimate an effect (e.g. important effect modification is ignored), or the weights are senseless - the models should not be fit.

Original languageEnglish (US)
Pages (from-to)214-222
Number of pages9
JournalJournal of Evaluation in Clinical Practice
Issue number1
StatePublished - Feb 2013
Externally publishedYes


  • causal diagrams
  • derived variables
  • inverse probability of treatment weighting
  • marginal structural models
  • standardization
  • thought bias

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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