gfoRmula: An R Package for Estimating the Effects of Sustained Treatment Strategies via the Parametric g-formula

Researchers are often interested in estimating the causal effects of sustained treatment strategies, i.e., of (hypothetical) interventions involving time-varying treatments. When using observational data, estimating those effects requires adjustment for confounding. However, conventional regression methods cannot appropriately adjust for confounding in the presence of treatment-confounder feedback. In contrast, estimators derived from Robins's g-formula may correctly adjust for confounding even if treatment-confounder feedback exists. The package gfoRmula implements in R one such estimator: the parametric g-formula. This estimator can be used to estimate the effects of binary or continuous time-varying treatments as well as contrasts defined by static or dynamic, deterministic, or random interventions, as well as interventions that depend on the natural value of treatment. The package accommodates survival outcomes as well as binary or continuous outcomes measured at the end of follow-up. This paper describes the gfoRmula package, along with motivating background, features, and examples.