Observational studies are regarded as economic alternatives to randomized trials, often used in their stead to investigate and determine treatment efficacy. Due to lack of sample size, observational studies commonly combine data from multiple sources or different sites/centers. Despite the benefits of an increased sample size, a naive combination of multicenter data may result in incongruities stemming from center-specific protocols for generating cohorts or reactions towards treatments distinct to a given center, among other things. These issues arise in a variety of other contexts, including capturing a treatment effect related to an individual's unique biological characteristics. Existing methods for estimating heterogeneous treatment effects have not adequately addressed the multicenter context, but rather treat it simply as a means to obtain sufficient sample size. Additionally, previous approaches to estimating treatment effects do not straightforwardly generalize to the multicenter design, especially when required to provide treatment insights for patients from a new, unobserved center. To address these shortcomings, we propose Multiple Domain Causal Networks (MDCN), an approach that simultaneously strengthens the information sharing between similar centers while addressing the selection bias in treatment assignment through learning of a new feature embedding. In empirical evaluations, MDCN is consistently more accurate when estimating the heterogeneous treatment effect in new centers compared to benchmarks that adjust solely based on treatment imbalance or general center differences. Finally, we justify our approach by providing theoretical analyses that demonstrate that MDCN improves on the generalization bound of the new, unobserved target center.
翻译:由于缺乏样本规模,观察研究通常将多个来源或不同地点/中心的数据合并在一起。尽管抽样规模增加的好处,但是对多个中心的数据进行天真的组合,可能导致因中心特定协议而产生的不一致,即产生组群,或对与特定中心不同的治疗作出反应,等等。为了克服这些缺陷,我们建议了多种新的环境,包括获取与个人独特的生物特征有关的治疗效果。现有的不同治疗效果估算方法没有适当处理多中心环境,而是仅仅将其作为获得足够样本规模的一种手段。此外,以往估算治疗效果的方法并不直接概括到多中心的设计,特别是当需要向来自新的、未观测的中心的病人提供治疗见解时。为了克服这些缺陷,我们建议了多多多多卡萨网络(MDCN),这一方法既能加强类似中心之间的信息共享,又能通过学习新的特征嵌入中心分析来消除治疗分配中的偏差,而只是将其作为获得足够样本规模的一种手段。此外,以往估算治疗效果的方法并没有直接概括地概括到多中心设计中,在持续地评估时,MDCN能够通过持续地解释中心分析来改善我们的总体治疗的平衡。