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arXiv 2306.09656cs.LGstat.ME
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通过点过程实现时间因果中介:医疗干预的直接效应与间接效应

Temporal Causal Mediation through a Point Process: Direct and Indirect Effects of Healthcare Interventions

Aalto University(阿尔托大学);Helsinki University Hospital(赫尔辛基大学医院);University of Helsinki(赫尔辛基大学)

Çağlar Hızlı, ST John, Anne Juuti, Tuure Saarinen, Kirsi Pietiläinen, Pekka Marttinen

AI总结:

针对现有动态因果中介分析的局限,提出基于时间点过程的非参数中介-结局模型,可准确估计医疗干预的直接与间接效应轨迹,在半合成和真实医疗数据上均验证有效。

摘要:

确定合适的干预措施需要构建包含治疗、结局及潜在中介变量的因果模型。因果中介分析可帮助我们区分干预的直接效应与间接效应,但此前大多在静态场景下开展研究。在医疗领域,数据以复杂、非均匀采样的时间序列形式存在,治疗、结局与中介变量之间随时间存在动态相互依赖关系。现有的动态因果中介分析方法仅适用于规则测量间隔、简单参数模型,且忽略了中介变量与结局之间的长程相互作用。为解决这些局限,我们提出一种非参数中介-结局模型,其中介变量被假定为与结局过程相互作用的时间点过程。借助该模型,我们估计了外部干预对结局的直接效应与间接效应,展示了二者如何影响整个未来轨迹。我们在半合成数据上验证了所提方法能够准确估计直接效应与间接效应;在真实医疗数据上,我们的模型推断出手术后血糖具有临床意义的直接效应与间接效应轨迹。

英文摘要:

Deciding on an appropriate intervention requires a causal model of a treatment, the outcome, and potential mediators. Causal mediation analysis lets us distinguish between direct and indirect effects of the intervention, but has mostly been studied in a static setting. In healthcare, data come in the form of complex, irregularly sampled time-series, with dynamic interdependencies between a treatment, outcomes, and mediators across time. Existing approaches to dynamic causal mediation analysis are limited to regular measurement intervals, simple parametric models, and disregard long-range mediator--outcome interactions. To address these limitations, we propose a non-parametric mediator--outcome model where the mediator is assumed to be a temporal point process that interacts with the outcome process. With this model, we estimate the direct and indirect effects of an external intervention on the outcome, showing how each of these affects the whole future trajectory. We demonstrate on semi-synthetic data that our method can accurately estimate direct and indirect effects. On real-world healthcare data, our model infers clinically meaningful direct and indirect effect trajectories for blood glucose after a surgery.

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

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