Causal inference in longitudinal observational health data often requires the accurate estimation of treatment effects on time-to-event outcomes in the presence of time-varying covariates. To tackle this sequential treatment effect estimation problem, we have developed a causal dynamic survival model (CDSM) that uses the potential outcomes framework with the Bayesian recurrent sub-networks to estimate the difference in survival curves. Using simulated survival datasets, CDSM has shown good causal effect estimation performance across scenarios of sample dimension, event rate, confounding and overlapping. However, we found increasing the sample size is not effective if the original data is highly confounded or with low level of overlapping. In two large clinical cohort studies, our model identified the expected conditional average treatment effect and detected individual effect heterogeneity over time and patient subgroups. The model provides individualized absolute treatment effect estimations that could be used in recommendation systems.
翻译:纵向观测健康数据的因果推断往往要求准确估计治疗对时间到活动结果的影响,如果存在时间变化的共差,则需要准确估计治疗对时间到活动结果的影响。为了解决这一连续治疗效果估计问题,我们开发了一个因果动态生存模型(CDSM),该模型与巴伊西亚经常性子网络一起,利用潜在结果框架来估计生存曲线的差异。利用模拟生存数据集,CDSM显示了良好的因果影响估计,在样本范围、事件率、混杂和重叠等不同情景中,我们发现,如果原始数据高度混杂或重叠程度低,则样本规模的增加是无效的。在两个大型临床组群研究中,我们的模型确定了预期的有条件平均治疗效应,并检测出个别效应在时间和病人分组中的异性。该模型提供了个别化绝对治疗效应估计,可用于建议系统。