Nonparametric efficient estimation of the longitudinal front-door functional

Abstract

The front-door criterion is an identification strategy for the intervention-specific mean outcome in settings where the standard back-door criterion fails due to unmeasured exposure-outcome confounders, but an intermediate variable exists that completely mediates the effect of exposure on the outcome and is not affected by unmeasured confounding. The front-door criterion has been extended to the longitudinal setting, where exposure and mediator vary over time. However, with the exception of a simple plug-in estimator, no suitable estimation techniques have been proposed. In this work, we derive nonparametric efficient estimators of the longitudinal front-door functional. The estimators accommodate high-dimensional mediators, are multiply robust, and allow for the use of data-adaptive methods for estimating nuisance functions while still providing valid inference. The theoretical properties of the estimators are illustrated in a simulation study, and we apply the estimators to a trial of peanut allergy in infants.