Tutorials › Propensity Score Matching and Instrumental Variables › The First Stage and Reduced-Form Contrast

IV Assumptions and Local Average Treatment Effects · Tutorial 450 of 699

The First Stage and Reduced-Form Contrast

Calculate the two instrument-group contrasts, interpret them in context, and diagnose what their size and direction do—and do not—tell you.

Advanced 10 min read

What You'll Learn

  • Define the first-stage contrast as the difference in treatment receipt between instrument groups.
  • Define the reduced-form contrast as the difference in outcomes between instrument groups.
  • Compute both contrasts from counts, proportions, and outcome means.
  • Distinguish an observed contrast from its causal interpretation under randomized encouragement.
  • Diagnose weak or unexpected contrasts without overinterpreting them.
  • Compare raw group differences with regression-based and covariate-adjusted contrasts.

Two Contrasts Across Instrument Values

In an encouragement study, an instrument such as an offer, reminder, or invitation may change whether people receive a treatment without determining receipt perfectly. A useful first step is to compare the two instrument groups separately on treatment receipt and on the outcome. These are distinct contrasts: one describes how strongly the instrument shifts receipt, and the other describes how outcomes differ across instrument values.

Let \(Z\in\{0,1\}\) denote the instrument, with \(Z=1\) representing the encouragement, and let \(D\in\{0,1\}\) denote treatment receipt. Let \(Y\) be the outcome. For a population, the relevant quantities are conditional means or probabilities. In a sample, they are estimated by the corresponding group proportions and means. Keep the direction fixed throughout: each contrast is the \(Z=1\) group minus the \(Z=0\) group.

Definition: The first-stage contrast is the difference in treatment receipt across instrument values: $$ \Delta_D = E[D\mid Z=1]-E[D\mid Z=0]. $$ For binary \(D\), each conditional expectation is the treatment-receipt proportion in that instrument group. The reduced-form contrast is the difference in mean outcomes across instrument values: $$ \Delta_Y = E[Y\mid Z=1]-E[Y\mid Z=0]. $$ In a sample, estimate these by replacing the population quantities with the corresponding group proportions or sample means.

The name “reduced form” refers here to the outcome contrast by instrument value, without conditioning on treatment receipt. It is not the treatment contrast between those who did and did not receive treatment. Receipt is affected by the instrument, and people in the two receipt groups may differ for reasons that also relate to outcomes.

When the Contrasts Have a Causal Interpretation

The two differences can always be calculated from observed group data when both instrument groups are represented. A causal interpretation requires more. For an encouragement randomly assigned to participants, assume that the assignment is independent of each participant’s potential treatment receipts and potential outcomes. Also assume consistency (the observed receipt and outcome equal the potential values corresponding to the instrument actually received) and no interference (one participant’s assignment does not change another participant’s receipt or outcome). Both instrument values must occur with positive probability.

Write \(D(z)\) for the treatment receipt a participant would have under instrument value \(z\), and \(Y(z)\) for the outcome under that value. Under these assumptions, the first-stage contrast identifies the average change in receipt caused by assignment to the encouragement, \(E[D(1)-D(0)]\). The reduced-form contrast identifies the average change in outcome caused by that assignment, \(E[Y(1)-Y(0)]\). These are effects of changing the instrument value, not automatically effects of changing treatment receipt.

The first-stage contrast is also a relevance check: a value near zero indicates little observed change in receipt across instrument groups. A nonzero first stage alone does not establish that the outcome contrast is caused only through treatment. That interpretation requires additional instrumental-variable assumptions, including exclusion; independence and monotonicity are also central to the later local-effect interpretation. Here, the task is to define and calculate the contrasts, not to combine them into a treatment-effect estimate.

Worked Example: Encouragement and a Continuous Outcome

In a hypothetical randomized study, participants are offered a program intended to increase use of a preventive service. The outcome is a follow-up wellbeing score, measured in points. The table reports treatment counts and the sum of outcome scores for each instrument group.

Encouragement \(Z\)ParticipantsReceived treatmentSum of outcome scores
112078552
012042480

First stage. The receipt proportions are \(78/120=0.650\) in the encouraged group and \(42/120=0.350\) in the unencouraged group. Therefore, $$ \widehat{\Delta}_D = \frac{78}{120}-\frac{42}{120} =0.650-0.350=0.300. $$ The encouragement group’s treatment-receipt rate is 30.0 percentage points higher.

Reduced form. The outcome means are \(552/120=4.60\) points and \(480/120=4.00\) points. Thus, $$ \widehat{\Delta}_Y = \frac{552}{120}-\frac{480}{120} =4.60-4.00=0.600\text{ points}. $$ The mean wellbeing score is 0.600 points higher in the encouraged group. Because the encouragement was randomized, this difference estimates the average effect of assignment to encouragement on the outcome, under the stated design assumptions. It is not, by itself, an estimate of the effect of receiving treatment.

Calculating the Contrasts from Different Data Summaries

The first stage is a difference in proportions when treatment receipt is binary. The reduced form is a difference in means, whether the outcome is binary or quantitative. For a binary outcome, its group mean is the proportion with outcome \(Y=1\), so the reduced-form contrast is a difference in outcome proportions. Group sizes need not be equal: each group’s proportion or mean must use its own denominator.

Worked Example: Unequal Group Sizes and a Binary Outcome

In a hypothetical randomized reminder study, treatment receipt is recorded for 100 participants assigned a reminder and 150 assigned no reminder. There are 70 recipients among those assigned a reminder and 75 among those assigned no reminder. A binary outcome occurs for 28 and 30 participants, respectively.

The first-stage contrast is $$ \widehat{\Delta}_D = \frac{70}{100}-\frac{75}{150} =0.700-0.500=0.200. $$ Treatment receipt is 20.0 percentage points more common in the reminder group.

The outcome proportions are \(28/100=0.280\) and \(30/150=0.200\). The reduced-form contrast is $$ \widehat{\Delta}_Y = \frac{28}{100}-\frac{30}{150} =0.280-0.200=0.080. $$ The outcome occurred 8.00 percentage points more often in the reminder group. Under randomized assignment and the other design conditions, this is an estimate of the effect of assignment to the reminder on the probability of the outcome. It does not establish that treatment receipt caused the difference.

The sign carries information, but only after the coding and subtraction order are clear. A positive first stage means receipt is more frequent under \(Z=1\); a negative first stage means it is less frequent. A positive reduced form means the outcome mean is higher under \(Z=1\). If the scientific outcome is undesirable, “higher” may represent a worse outcome. Always report the outcome’s meaning and units rather than treating a positive sign as inherently beneficial.

Worked Example: A Small First-Stage Contrast

Consider another hypothetical randomized encouragement study. Of 200 participants assigned encouragement, 104 receive treatment; of 200 assigned no encouragement, 100 receive treatment. The average outcome is 3.18 units in the encouragement group and 3.15 units in the other group.

The first-stage contrast is $$ \widehat{\Delta}_D = \frac{104}{200}-\frac{100}{200} =0.520-0.500=0.020. $$ The encouragement group’s receipt rate is only 2.00 percentage points higher. The reduced-form contrast is $$ \widehat{\Delta}_Y = 3.18-3.15=0.030\text{ outcome units}. $$ The observed mean outcome is 0.030 units higher under encouragement. The small first-stage contrast flags that assignment produced little change in receipt in this sample. These two point estimates alone do not determine whether either difference is distinguishable from sampling variation: that requires uncertainty estimates and an appropriate analysis. Nor does the small first stage justify interpreting the outcome difference as a treatment effect.

Why the Group Differences Identify Assignment Effects

The causal justification for the raw differences is short but important. Under random assignment, the instrument value is independent of the potential receipts and outcomes. Consistency connects the observed values to the potential values for the assigned instrument. For the first stage:

$$ \begin{aligned} E[D\mid Z=1]-E[D\mid Z=0] &=E[D(1)\mid Z=1]-E[D(0)\mid Z=0]\\ &=E[D(1)]-E[D(0)]\\ &=E[D(1)-D(0)]. \end{aligned} $$

The first equality uses consistency, and the second uses random assignment. The final equality follows from linearity of expectation. Replacing \(D\) with \(Y\) gives the corresponding result for the reduced form:

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

This argument identifies effects of assignment to the instrument. It does not require the exclusion restriction, because assignment may affect outcomes directly and the reduced-form contrast still measures the total effect of assignment. Exclusion matters when seeking to attribute outcome changes solely to treatment receipt. Without it, the reduced form can include effects of the encouragement itself, such as added information or attention.

Diagnostics, Alternatives, and Limitations

Start with a simple audit of the data: verify which value is coded \(Z=1\), check that both groups have observations, confirm the denominators, and ensure outcome summaries use the same measurement and follow-up definition in both groups. Then calculate each group’s receipt rate and outcome mean before subtracting. This makes direction errors and denominator mistakes easier to catch.

If the first stage is near zero, the instrument may be weakly related to receipt in the study population. If a supposedly strong encouragement has an unexpected sign, check the coding, assignment process, and receipt definition before offering a substantive explanation. Imbalance in baseline characteristics after a randomized assignment can occur by chance; extensive imbalance may also signal problems with implementation, missing data, or analysis. In a nonrandomized instrument study, observed group differences may reflect confounding, so raw contrasts do not automatically identify causal effects.

The raw mean difference is a transparent way to report each contrast. With a binary instrument, a regression of \(D\) on an intercept and \(Z\) gives a coefficient on \(Z\) equal to the raw first-stage difference; regressing \(Y\) on an intercept and \(Z\) similarly gives the raw reduced-form difference. Regression can be useful for uncertainty estimates or adjustment for prespecified covariates. In randomized studies, covariate adjustment may improve precision, but the adjusted analysis must be stated clearly and should not conceal the unadjusted group summaries. In observational studies, adjustment only supports a causal interpretation if the required conditional independence and modeling assumptions are credible.

The contrasts have limitations. They summarize average group differences and do not describe every participant’s response. A nonzero first stage does not prove instrument validity, and a reduced-form difference does not isolate the pathway through treatment. Sampling uncertainty matters, especially with small groups or a small first stage. Report standard errors or confidence intervals when making inferential claims, and keep those claims separate from the descriptive arithmetic.

Common pitfall: “The outcome is higher among treated participants, so the reduced-form effect is positive.” This compares groups defined by \(D\), not by \(Z\). The reduced-form contrast must compare outcomes across instrument values, \(E[Y\mid Z=1]-E[Y\mid Z=0]\). Treatment groups can differ in ways that make their outcome comparison confounded.

Check Your Understanding

For each question, identify the relevant contrast and keep the \(Z=1\) minus \(Z=0\) direction.

  1. A study has receipt rates of 0.72 for \(Z=1\) and 0.54 for \(Z=0\). What is the first-stage contrast, and what does its sign mean?
  2. Outcome means are 12.4 units for \(Z=1\) and 13.1 units for \(Z=0\). What is the reduced-form contrast?
  3. Why is the difference in outcome means between treatment recipients and nonrecipients not the reduced-form contrast?
  4. In a randomized study, does identifying the reduced-form effect of assignment require the exclusion restriction? Explain briefly.

Solutions. (1) \(0.72-0.54=0.18\): receipt is 18 percentage points more common under \(Z=1\). (2) \(12.4-13.1=-0.7\) units: the mean outcome is 0.7 units lower under \(Z=1\). (3) The reduced form compares instrument groups, not receipt groups; receipt may be related to participant characteristics that also affect outcomes. (4) No. Random assignment and consistency identify the total effect of assignment on the outcome; exclusion is needed to rule out a direct effect of the instrument when attributing outcome changes to treatment receipt.

Clinical Biostats