Causal assumptions
The ATE (average treatment effect) estimand used in this study is based upon the Potential Outcomes Framework. If a set of assumptions is met, then causal interpretation can be made. The causal assumptions are counterfactual consistency, ignorability (conditional exchangeability), and positivity. Counterfactual consistency means that the definition of exposure is consistent for all individuals. Ignorability states that treatment assignment can be considered random after controlling for, conditioning on, a set of covariates [To best emulate a target trial, it must be possible for all participants to potentially receive both treatments. To ensure the assumptions underlying our causal approach were as robust as possible, we considered our observational data in direct comparison with the conditions of a target trial (