{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:30:02Z","timestamp":1791862202721,"version":"4.3.4"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:00:00Z","timestamp":1706659200000},"content-version":"vor","delay-in-days":205,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:00:00Z","timestamp":1688947200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>A difficult decision for patients in need of kidney\u2013pancreas transplant is whether to seek a living kidney donor or wait to receive both organs from one deceased donor. The framework of dynamic treatment regimes (DTRs) can inform this choice, but a patient-relevant strategy such as \u201cwait for deceased-donor transplant\u201d is ill-defined because there are multiple versions of treatment (i.e., wait times, organ qualities). Existing DTR methods average over the distribution of treatment versions in the data, estimating survival under a \u201crepresentative intervention.\u201d This is undesirable if transporting inferences to a target population such as patients today, who experience shorter wait times thanks to evolutions in allocation policy. We, therefore, propose the concept of a generalized representative intervention (GRI): a random DTR that assigns treatment version by drawing from the distribution among strategy compliers in the target population (e.g., patients today). We describe an inverse-probability-weighted product-limit estimator of survival under a GRI that performs well in simulations and can be implemented in standard statistical software. For continuous treatments (e.g., organ quality), weights are reformulated to depend on probabilities only, not densities. We apply our method to a national database of kidney\u2013pancreas transplant candidates from 2001\u20132020 to illustrate that variability in transplant rate across years and centers results in qualitative differences in the optimal strategy for patient survival.<\/jats:p>","DOI":"10.1111\/biom.13899","type":"journal-article","created":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T06:21:14Z","timestamp":1689056474000},"page":"3165-3178","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Transportability of Causal Inference under Random Dynamic Treatment Regimes for Kidney\u2013Pancreas Transplantation"],"prefix":"10.1093","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1408-851X","authenticated-orcid":false,"given":"Grace R.","family":"Lyden","sequence":"first","affiliation":[{"name":"Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute , Minneapolis, Minnesota , USA"},{"name":"Division of Biostatistics, School of Public Health, University of Minnesota , Minneapolis, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5459-9579","authenticated-orcid":false,"given":"David M.","family":"Vock","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, School of Public Health, University of Minnesota , Minneapolis, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5170-7100","authenticated-orcid":false,"given":"Erika S.","family":"Helgeson","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, School of Public Health, University of Minnesota , Minneapolis, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik B.","family":"Finger","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery, University of Minnesota , Minneapolis, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur J.","family":"Matas","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery, University of Minnesota , Minneapolis, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7974-8940","authenticated-orcid":false,"given":"Jon J.","family":"Snyder","sequence":"additional","affiliation":[{"name":"Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute , Minneapolis, Minnesota , USA"},{"name":"Department of Medicine, University of Minnesota , Minneapolis, Minnesota , USA"},{"name":"Division of Epidemiology & Community Health, School of Public Health, University of Minnesota , Minneapolis, Minnesota , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,7,10]]},"reference":[{"key":"2024020107185560200_biom13899-bib-0001","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1001\/jama.2016.10924","article-title":"Clinical manifestations of kidney disease among US adults with diabetes, 1988-2014","volume":"316","author":"Afkarian","year":"2016","journal-title":"JAMA"},{"key":"2024020107185560200_biom13899-bib-0002","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1111\/j.1600-6143.2009.02996.x","article-title":"Systematic evaluation of pancreas allograft quality, outcomes and geographic variation in utilization","volume":"10","author":"Axelrod","year":"2010","journal-title":"American Journal of Transplantation"},{"key":"2024020107185560200_biom13899-bib-0003","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1111\/biom.12921","article-title":"Estimating the causal effect of treatment regimes for organ transplantation","volume":"74","author":"Boatman","year":"2018","journal-title":"Biometrics"},{"key":"2024020107185560200_biom13899-bib-0004","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4614-4818-1","volume-title":"Essential statistical inference","author":"Boos","year":"2013"},{"key":"2024020107185560200_biom13899-bib-0005","doi-asserted-by":"crossref","first-page":"18","DOI":"10.2202\/1557-4679.1212","article-title":"When to start treatment? 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