Causal inference for the expected number of recurrent events in the presence of a terminal event

Abstract: We study causal inference and efficient estimation for the expected number of recurrent events in the presence of a terminal event. We define our estimand as the vector comprising both the expected number of recurrent events and the failure survival function evaluated along a sequence of landmark times. We identify the estimand in the presence of right-censoring and causal selection as an observed data functional under coarsening at random, derive the nonparametric efficiency bound, and propose a multiply-robust estimator that achieves the bound and permits nonparametric estimation of nuisance parameters. Throughout, no absolute continuity assumption is made on the underlying probability distributions of failure, censoring, or the observed data. Additionally, we derive the class of influence functions when the coarsening distribution is known and review how published estimators may belong to the class. Along the way, we highlight some interesting inconsistencies in the causal lifetime analysis literature.