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ICMHI 2021 : 2021 5th International Conference on Medical and Health Informatics : May 14-16, 2021, Kyoto, Japan. International Conference on Medical and Health Informatics (5th : 2021 : Online)最新文献

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Causal AI with Real World Data: Do Statins Protect from Alzheimer's Disease Onset? 基于真实世界数据的因果AI:他汀类药物是否能预防阿尔茨海默病的发作?
Mattia Prosperi, Marco Salemi, Shantanu Ghosh, Tianchen Lyu, Jiang Bian, Zhaoyi Chen, Jinying Zhao

Causal artificial intelligence aims at developing bias-robust models that can be used to intervene on, rather than just be predictive, of risks or outcomes. However, learning interventional models from observational data, including electronic health records (EHR), is challenging due to inherent bias, e.g., protopathic, confounding, collider. When estimating the effects of treatment interventions, classical approaches like propensity score matching are often used, but they pose limitations with large feature sets, nonlinear/nonparallel treatment group assignments, and collider bias. In this work, we used data from a large EHR consortium -OneFlorida- and evaluated causal statistical/machine learning methods for determining the effect of statin treatment on the risk of Alzheimer's disease, a debated clinical research question. We introduced a combination of directed acyclic graph (DAG) learning and comparison with expert's design, with calculation of the generalized adjustment criterion (GAC), to find an optimal set of covariates for estimation of treatment effects -ameliorating collider bias. The DAG/CAC approach was assessed together with traditional propensity score matching, inverse probability weighting, virtual-twin/counterfactual random forests, and deep counterfactual networks. We showed large heterogeneity in effect estimates upon different model configurations. Our results did not exclude a protective effect of statins, where the DAG/GAC point estimate aligned with the maximum credibility estimate, although the 95% credibility interval included a null effect, warranting further studies and replication.

因果人工智能旨在开发可用于干预(而不仅仅是预测)风险或结果的偏见稳健模型。然而,从包括电子健康记录(EHR)在内的观测数据中学习介入模型是具有挑战性的,因为存在固有的偏见,例如原发性、混杂性和对撞性。在评估治疗干预的效果时,通常使用倾向评分匹配等经典方法,但它们在大型特征集、非线性/非并行治疗组分配和碰撞器偏差方面存在局限性。在这项工作中,我们使用了来自一个大型电子病历联盟——oneflorida的数据,并评估了因果统计/机器学习方法,以确定他汀类药物治疗对阿尔茨海默病风险的影响,这是一个有争议的临床研究问题。我们引入了有向无环图(DAG)学习和专家设计比较的结合,并计算广义调整准则(GAC),以找到一组最优协变量来估计治疗效果-改善对撞机偏差。DAG/CAC方法与传统的倾向评分匹配、逆概率加权、虚拟孪生/反事实随机森林和深度反事实网络一起进行了评估。我们在不同模型配置的效果估计中显示了很大的异质性。我们的结果没有排除他汀类药物的保护作用,其中DAG/GAC点估计与最大可信度估计一致,尽管95%的可信区间包括零效应,需要进一步的研究和复制。
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ICMHI 2021 : 2021 5th International Conference on Medical and Health Informatics : May 14-16, 2021, Kyoto, Japan. International Conference on Medical and Health Informatics (5th : 2021 : Online)
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