A smart healthcare system that supports clinicians for risk-calibrated treatment assessment typically requires the accurate modeling of time-to-event outcomes. To tackle this sequential treatment effect estimation problem, we developed causal dynamic survival model (CDSM) for causal inference with survival outcomes using longitudinal electronic health record (EHR). CDSM has impressive explanatory performance while maintaining the prediction capability of conventional binary neural network predictors. It borrows the strength from explanatory framework including the survival analysis and counterfactual framework and integrates them with the prediction power from a deep Bayesian recurrent neural network to extract implicit knowledge from EHR data. In two large clinical cohort studies, our model identified the conditional average treatment effect in accordance with previous literature yet detected individual effect heterogeneity over time and patient subgroups. The model provides individualized and clinically interpretable treatment effect estimations to improve patient outcomes.

Keep it casual with the Casual Inference podcast. Your hosts Lucy D'Agostino McGowan and Ellie Murray talk all things epidemiology, statistics, data science, causal inference, and public health.

Over the past decades, statisticians and machine-learning researchers have developed literally thousands of new tools for the reduction of high-dimensional data in order to identify the variables most responsible for a particular trait. These tools have applications in a plethora of settings, including data analysis in the fields of business, education, forensics, and biology (such as microarray, proteomics, brain imaging), to name a few. In the present work, we focus our investigation on the limitations and potential misuses of certain tools in the analysis of the benchmark colon cancer data (2,000 variables; Alon et al., 1999) and the prostate cancer data (6,033 variables; Efron, 2010, 2008). Our analysis demonstrates that models that produce 100% accuracy measures often select different sets of genes and cannot stand the scrutiny of parameter estimates and model stability. Furthermore, we created a host of simulation datasets and "artificial diseases" to evaluate the reliability of commonly used statistical and data mining tools. We found that certain widely used models can classify the data with 100% accuracy without using any of the variables responsible for the disease. With moderate sample size and suitable pre-screening, stochastic gradient boosting will be shown to be a superior model for gene selection and variable screening from high-dimensional datasets.