Tutorials › Causal Inference › Assignment Effects, First Stages, and Reduced Forms

Instrumental Variable Extensions · Tutorial 557 of 972

Assignment Effects, First Stages, and Reduced Forms

Calculate first-stage and reduced-form contrasts from randomized groups, and interpret what they do—and do not—say about treatment receipt.

Advanced 10 min read

What You'll Learn

  • Define assignment effects on treatment uptake and on outcomes.
  • Calculate first-stage contrasts from treatment-uptake proportions.
  • Calculate reduced-form contrasts for continuous and binary outcomes.
  • Interpret contrast direction and units in context.
  • Distinguish the effect of assignment from the effect of receiving treatment.
  • Identify assumptions needed to interpret randomized-group differences causally.

Why Separate Assignment From Treatment Receipt?

In an encouragement study, people may be randomly assigned to receive an offer, reminder, or other encouragement, but assignment does not guarantee that they take up the treatment. The randomized groups therefore differ directly in assignment; they may also differ in how often people receive the treatment and in their outcomes. Keeping these distinctions clear is essential: a randomized comparison identifies effects of assignment, not automatically effects of treatment receipt.

This tutorial focuses on two contrasts. The first stage is the effect of assignment on treatment uptake. The reduced form is the effect of assignment on the outcome. Both compare people according to the group to which they were assigned, whether or not they followed the assignment.

Potential Outcomes and the Two Assignment Effects

Let \(Z=1\) indicate assignment to the encouragement group and \(Z=0\) indicate assignment to the comparison group. Let \(D=1\) indicate that a person received the treatment and \(D=0\) indicate that they did not. Let \(Y\) be the outcome of interest. For each person, \(D(z)\) is the treatment uptake that would occur under assignment \(z\), and \(Y(z)\) is the outcome that would occur under assignment \(z\). The outcome \(Y(z)\) can reflect everything assignment changes, including any change in treatment uptake.

Definition: The first-stage assignment effect is \(E[D(1)-D(0)]\), the average effect of assignment on treatment uptake. The reduced-form assignment effect is \(E[Y(1)-Y(0)]\), the average effect of assignment on the outcome. When assignment is randomized, these effects are estimated by comparing the assigned groups, not by regrouping people according to treatment received.

Because \(D\) is binary, its group mean is the proportion receiving treatment. Thus the first stage is the difference in treatment-uptake proportions. The reduced form is the difference in mean outcomes when \(Y\) is quantitative, or the difference in outcome proportions when \(Y\) is binary. State which group is subtracted from which: throughout, the contrast is assignment to encouragement minus assignment to comparison.

These are effects of the assignment policy. For example, the reduced form answers, “What is the average outcome difference caused by being assigned to the encouragement rather than the comparison group?” It does not, by itself, answer, “What is the effect of receiving the treatment?”

When Does a Randomized Contrast Have a Causal Interpretation?

The key design condition is that assignment is randomized, so assignment is independent of the potential outcomes and potential uptake. The usual interpretation also requires consistency: each person’s observed uptake and outcome equal the values corresponding to the assignment they actually received. It requires no interference between people, so one person’s assignment does not change another person’s potential uptake or outcome. Finally, the assigned groups must have usable outcome data; differential loss to follow-up can undermine a comparison if the observed participants no longer represent the randomized groups.

Under these conditions, the difference in observed group means identifies the corresponding average assignment effect. For example, randomization makes the people assigned \(Z=1\) comparable, on average, to those assigned \(Z=0\) in their potential outcomes. Consistency then links each observed group mean to the potential outcome under that group’s assignment.

$$ E[D\mid Z=1]-E[D\mid Z=0] =E[D(1)\mid Z=1]-E[D(0)\mid Z=0] =E[D(1)]-E[D(0)]. $$

The first equality uses consistency, and the second uses random assignment. Replacing \(D\) with \(Y\) gives the same justification for the reduced form. In a sample, the corresponding estimators are the observed difference in group means. In a randomized experiment, these estimators target the average assignment effects; sampling variation means a particular sample difference need not equal the population effect exactly.

$$ \widehat{\tau}_D =\bar{D}_{Z=1}-\bar{D}_{Z=0} =\hat{p}_{Z=1}-\hat{p}_{Z=0}, \qquad \widehat{\tau}_Y =\bar{Y}_{Z=1}-\bar{Y}_{Z=0}. $$

Here \(\hat{p}_{Z=1}\) and \(\hat{p}_{Z=0}\) are the observed treatment-uptake proportions in the two assignment groups. For a binary outcome, the second contrast is likewise a difference in proportions. Neither contrast requires that everyone comply with their assignment. Nor does identifying these assignment effects require an assumption that assignment affects the outcome only through treatment receipt. That distinction matters: the reduced form is about assignment itself.

Worked Calculations

Worked Example: First Stage and Reduced Form for a Continuous Outcome

In a hypothetical randomized encouragement study, 120 people are assigned to an encouragement and 120 to a comparison group. Treatment is received by 78 people in the encouragement group and 42 in the comparison group. Their average numbers of symptom-free days over a specified follow-up period are 8.4 and 7.2 days, respectively. The outcome standard deviations are 3.0 and 3.2 days. Assume assignment was implemented as randomized, the variables are consistently recorded, and no person’s assignment affects another person’s outcome.

First stage. The uptake proportions are \(78/120=0.650\) and \(42/120=0.350\). Thus

$$ \widehat{\tau}_D =\frac{78}{120}-\frac{42}{120} =0.650-0.350 =0.300. $$

Assignment to encouragement increased treatment uptake by an estimated 0.300, or 30.0 percentage points, compared with assignment to the comparison group.

Reduced form. The estimated difference in mean symptom-free days is

$$ \widehat{\tau}_Y =8.4-7.2 =1.2\text{ days}. $$

The encouragement assignment group averaged 1.2 more symptom-free days during follow-up. This is the estimated effect of assignment on the outcome in this study, not an estimate of the effect of receiving treatment.

For a rough large-sample measure of precision, use the independent-group standard error for the difference in uptake proportions:

$$ SE(\widehat{\tau}_D) =\sqrt{\frac{0.650(1-0.650)}{120} +\frac{0.350(1-0.350)}{120}} \approx 0.0616. $$

An approximate 95% interval is \(0.300\pm1.96(0.0616)\), or \(0.179\) to \(0.421\). Under the stated approximation, this interval ranges from an 17.9- to a 42.1-percentage-point increase in uptake. For the continuous outcome, the corresponding standard error is

$$ SE(\widehat{\tau}_Y) =\sqrt{\frac{3.0^2}{120}+\frac{3.2^2}{120}} \approx 0.400\text{ days}. $$

The approximate 95% interval is \(1.2\pm1.96(0.400)\), or 0.416 to 1.984 days. These are conventional large-sample intervals; the uncertainty calculation should reflect the actual randomization and sampling design when those features require a design-specific method.

Worked Example: Reduced Form for a Binary Outcome

In a hypothetical study, 200 people are assigned to an encouragement and 200 to a comparison group. Treatment uptake is 120/200 in the encouragement group and 80/200 in the comparison group. A binary adverse outcome occurs in 34 people in the encouragement group and 46 in the comparison group. Suppose assignment was randomized, follow-up is complete, and the outcome is measured consistently.

The first-stage contrast is

$$ \widehat{\tau}_D =\frac{120}{200}-\frac{80}{200} =0.600-0.400 =0.200. $$

Thus assignment to encouragement increased treatment uptake by an estimated 20.0 percentage points. The adverse-outcome proportions are \(34/200=0.170\) and \(46/200=0.230\). The reduced form is

$$ \widehat{\tau}_Y =\frac{34}{200}-\frac{46}{200} =0.170-0.230 =-0.060. $$

The estimated assignment effect is a 6.00-percentage-point reduction in the adverse-outcome risk. A conventional standard error is

$$ SE(\widehat{\tau}_Y) =\sqrt{\frac{0.170(0.830)}{200} +\frac{0.230(0.770)}{200}} \approx 0.0399. $$

An approximate 95% interval is \(-0.060\pm1.96(0.0399)\), or \(-0.138\) to \(0.018\). In context, the data are compatible with an assignment-associated reduction of 13.8 percentage points or an increase of 1.8 percentage points, under this interval procedure. The interval includes zero; the point estimate’s negative sign alone does not establish that the assignment reduced the outcome.

Worked Example: Unequal Assignment-Group Sizes

In another hypothetical randomized study, 90 people are assigned to an encouragement and 60 to a comparison group. Treatment is received by 54 and 24 people, respectively. The average outcome is 5.1 units in the encouragement group and 4.6 units in the comparison group. Assume the same randomization, consistency, and no-interference conditions described above.

The uptake proportions are \(54/90=0.600\) and \(24/60=0.400\), so the first stage is

$$ \widehat{\tau}_D =0.600-0.400 =0.200. $$

Assignment to encouragement increased uptake by an estimated 20.0 percentage points. The reduced form is

$$ \widehat{\tau}_Y =5.1-4.6 =0.5\text{ outcome units}. $$

The encouragement group’s mean outcome was 0.5 units higher. The group means are calculated within each assignment group, so unequal group sizes do not change the definition of the contrast. They do affect how much information each group contributes and therefore can affect precision.

The reported 0.5-unit difference is not the effect of treatment receipt. Randomization applies to \(Z\), not to \(D\): people who receive treatment may differ from those who do not for reasons related to their outcomes. The randomized contrast remains a causal comparison of assignment groups under the stated assumptions, but this calculation alone does not identify what would happen if treatment receipt itself were assigned.

How to Report Each Contrast

A clear report names the randomized groups, gives the contrast direction, states the quantity and units, and identifies the effect as an effect of assignment. For example: “Assignment to the encouragement increased treatment uptake by 20.0 percentage points and was associated with an estimated 0.5-unit increase in the outcome mean, compared with assignment to the control.” When randomization and measurement conditions support causal interpretation, “effect of assignment” is appropriate. Avoid wording that turns the reduced form into an effect of treatment receipt.

The first stage also helps describe how much the encouragement changed behavior. A small first stage means the assigned groups had similar treatment-uptake rates; a larger one means uptake differed more. But the first stage is not an outcome benefit, and a large first stage by itself says nothing about whether the outcome improved. The reduced form answers a separate question about the outcome difference between assignment groups.

Common Mistake: Comparing Recipients as if Receipt Were Randomized

A common error is to compare outcomes among people who received treatment with outcomes among those who did not, then attribute that difference to treatment. The reasoning is: “The treatment group had better outcomes, so treatment caused the difference.” The problem is that receipt happens after assignment. People who take up treatment can differ systematically from people who do not, so this comparison does not preserve the balance created by randomization.

The correction is to compare groups by their randomized assignment when estimating assignment effects. Calculate the first stage from uptake rates by assignment and the reduced form from outcome means or proportions by assignment. Report each in its own terms. These contrasts may be useful even when not everyone takes up treatment, because they describe what assignment to the encouragement actually changes.

Key takeaway: The first stage is the randomized assignment contrast in treatment uptake; the reduced form is the randomized assignment contrast in outcomes. Interpret both as effects of assignment. Neither is, by definition, the effect of receiving treatment.

Check Your Understanding

Answer each question by keeping the assignment contrast separate from treatment receipt.

  1. In a randomized study, uptake is 45% in the encouragement group and 30% in the comparison group. Calculate the first stage and state its units.
  2. Mean blood-pressure change is \(-4.2\) mmHg in the encouragement group and \(-2.7\) mmHg in the comparison group. Calculate the reduced form and interpret its sign in context.
  3. What randomization condition justifies interpreting the difference in outcome means as an assignment effect?
  4. Why does a randomized assignment not make a comparison of treatment recipients and nonrecipients randomized?
  5. Does identifying the reduced-form assignment effect require assuming that assignment affects outcomes only through treatment uptake? Explain.
Clinical Biostats