Understanding the effects of interventions is central to scientific progress, with randomized controlled trials (RCTs) regarded as the gold standard for causal inference in many applied fields. However, RCTs are costly, time-consuming, and often constrained by ethical or practical limitations, motivating the need for causal methods able to draw conclusions from observational data. While such data is collected at ever larger scale, making its use for causal inference is often hindered by the fact that not all variables affecting treatment allocation and the outcome are observed - an issue known as unobserved confounding. In this paper, we introduce a new study design called confounder detection via treatment intent. The idea is to query a human expert who makes treatment decisions, and ask them to compare pairs of units proposed by a principled matching strategy, with the goal of eliciting unobserved variables that explain why treatment decisions differ. We provide a theoretical basis for such a procedure, ascertaining conditions under which such a study design may elicit unobserved confounders. Building on this newly established foundations, we study treatment effects of interventions in the intensive care unit (ICU). First, we show empirical evidence strongly indicating that electronic health records (EHRs) collected in ICUs are subject to unobserved confounding. By using clinical text notes as a proxy for physicians' knowledge and leveraging natural language processing, we provide a proof of concept for our methodology in a semi-synthetic environment with a known ground truth.

Predictive models trained on observational data often fail to generalise to the distributions they encounter when deployed, especially when the training data is a product of the system being optimised. Recommender systems are a canonical example: they are trained on interaction logs confounded by the deployed policy, past user behaviour, and platform filtering. As a result, the training distribution differs substantially from the candidate distribution scored at serving time, a gap that makes offline metrics unreliable predictors of online performance. We address the distribution shift problem with a method motivated by causal representation learning (CRL). We propose an information-theoretic disentanglement criterion and prove that its optimum depends only on the causal components of the input. We then derive a tractable variational lower bound that makes the criterion optimisable from finite observational data alone. The scope of our method is narrower than that of much of the CRL literature, in that we target better generalisation under distribution shift, not full identification of all latent causal factors. This narrower target is what makes the method practical, requiring only the existing confounded logs, applying to any standard supervised model, and adding no inference-time cost. Our headline evaluation is an A/B test with millions of users on Spotify, applied to a production ranker for personalised playlist generation. A capacity-matched CRL variant performed on par offline but delivered substantial online gains in listener engagement. Complementary evidence on the public KuaiRand recommendation dataset and a synthetic benchmark with known causal structure shows the same pattern: offline parity with baseline, gains under distribution shift. Across all three settings, adding our causal disentanglement objective yields meaningfully better out-of-distribution generalisation.

Predicting the effect of interventions with many possible variations, e.g., therapeutic content that affects mental health outcomes or an earnings call transcript that drives movement in share price, is useful across several domains. However, classical causal estimators tend to assume that all possible interventions are observed, which is infeasible when interventions vary widely, for instance, in the space of all text strings. We adapt a well-known approach of recasting causal inference as a learning problem, to address high-dimensional treatment spaces. Specifically, under standard assumptions like no unobserved confounding, we show that causal error decomposes into a series of moment-balancing errors of increasing order, and design objectives that directly improve causal estimation. We also show how to project the effect of a high-dimensional treatment onto lower-dimensional treatment attributes, which allows a single model to answer several causal questions without additional attribute-specific training. We empirically evaluate our estimators in settings with high-dimensional continuous, discrete, and text treatments, the last of which used a semi-synthetic dataset of Amazon Reviews. Our experiments demonstrate the benefit of higher-order balance error optimization and competitive performance of projected causal estimates with attribute-specific estimators.

Unobserved confounding is a fundamental challenge for estimating causal effects. To address unobserved confounding, recent literature has turned to two different approaches -- proxy variables and the use of multiple treatments. The first approach, commonly referred to as proximal causal inference, requires proxies to be assigned to specific asymmetric roles: treatment-inducing proxies (negative control exposures), variables that act as common causes of the treatment and outcome, and outcome-inducing proxies (negative control outcomes). In practice, however, identifying variables that satisfy these asymmetric roles can be difficult depending on the application domain. The second approach, commonly referred to as the ``Deconfounder," deals with multiple conditionally independent treatments. There has been limited progress towards developing a consistent estimation method for this setting. As the primary contribution of this work, we establish that causal effects are identifiable in both settings when the unobserved confounder is categorical under suitable conditions. Our approach builds on a mixture learning perspective: we show that the underlying confounding structure can be recovered by identifying the corresponding mixture distribution. We propose an estimation procedure based on tensor decomposition, which allows consistent recovery of the latent structure and comes with non-asymptotic guarantees. Simulation studies and real data experiments demonstrate that the proposed method performs well even with limited data.

Single-arm trials are an important study design for evaluating drug efficacy and safety without enrolling patients into a control arm. Although they do not provide the gold-standard evidence of randomized controlled trials, they are increasingly used in clinical development as they offer an efficient, ethical, and practical alternative. A wide variety of approaches can be used to construct control comparators and estimate treatment effects, from fixed comparators informed by clinical knowledge to data-based and model-based patient-level comparators, also known as synthetic controls. Powerful and flexible machine learning models can allow outcome-model-based synthetic controls to overcome key limitations of direct data-based approaches, yield more robust estimates of treatment effects, and provide a principled way to incorporate corrections or encode additional assumptions when external data are not directly comparable. In this work, we argue that outcome-model-based synthetic control arms are an important tool for single-arm trials. We focus on digital twins, personalized predictions of disease progression generated from machine learning models trained on historical datasets, which naturally leverage these flexible approaches. We review doubly robust estimators, present power and sample size formulas, and discuss trade-offs in selecting historical data for training and analysis. We also outline practical considerations for deploying digital twins within the framework of recent FDA draft guidance on the use of artificial intelligence in drug development. Finally, we reanalyze data from trials in amyotrophic lateral sclerosis and Huntington's disease to demonstrate the proposed methods.

Mediation analysis (Robins & Greenland 1992, Pearl 2001, Imai, Keele & Tingley 2010, Tchetgen Tchetgen & Shpitser 2012) provides a principled framework for investigating causal mechanisms by decomposing the effect of a treatment A on an outcome Y into pathways operating through a mediator of interest M. Classical mediation analysis focuses on the natural indirect effect, corresponding to the pathway from Ato Y through M, and the natural direct effect, corresponding to pathways not through M. These estimands are well understood when a single mediator is present and strong identification assumptions hold. However, in many applications, there exist multiple intermediate variables between treatment and outcome. In such settings, conventional mediation analysis typically requires the absence of treatment-induced mediator-outcome confounders--often referred to as recanting witnesses--as well as the absence of unmeasured confounding. Under these circumstances, commonly used identification assumptions such as sequential ignorability (Imai, Keele & Yamamoto 2010) or nonparametric structural equation models with independent errors (NPSEM-IE) (Pearl 2009) no longer suffice to identify natural indirect effects (Avin et al. 2005, Tchetgen Tchetgen & VanderWeele 2014). Figure 1 illustrates this issue: the recanting witness D is directly affected by A and simultaneously confounds the relationship between M and Y. Such treatment-induced confounding is common in epidemiologic studies, particularly when the mediator of interest occurs long after the treatment initiation (Robins 1999). A motivating example arises in studies of preterm birth. Mediation analysis has been widely used to explore whether adequate prenatal care (A) reduces the risk of preterm birth (Y) through preeclampsia (M) (Vansteelandt & VanderWeele 2012, VanderWeele et al. 2014, Xia & Chan 2023).

We develop a Bayesian tree ensemble model to estimate heterogeneous treatment effects in censored survival data with high-dimensional covariates. Instead of imposing sparsity through the tree structure, we place a horseshoe prior directly on the step heights to achieve adaptive global-local shrinkage. This strategy allows flexible regularisation and reduces noise. We develop a reversible jump Gibbs sampler to accommodate the non-conjugate horseshoe prior within the tree ensemble framework. We show through extensive simulations that the method accurately estimates treatment effects in high-dimensional covariate spaces, at various sparsity levels, and under non-linear treatment effect functions. We further illustrate the practical utility of the proposed approach by a re-analysis of pancreatic ductal adenocarcinoma (PDAC) survival data from The Cancer Genome Atlas.

Incorporating causality into reinforcement learning methods increases the interpretability of artificial636 intelligence, which helps humans understand the underlying mechanism of algorithms and check637 the source of failures. However, the learned causal transition model may contain human-readable638 private information about the environment, which could raise privacy issues. To mitigate this potential639 negative societal impact, the causal transition model needs to be encrypted and only accessible to640 algorithms and trustworthy users.641 In this section, besides the most related formulation, robust RL introduced in Sec 3.3, we also643 introduce some other related RL problem formulations partially shown in Figure 3. Then, we limit644 our discussion to mainly two lines of work that are related to ours: (1) promoting robustness in RL;645 (2) concerning the spurious correlation issues in RL.646 B.1 Related RL formulations647 Robustness to noisy state: POMDPs and SA-MDPs.

Robustness has been extensively studied in reinforcement learning (RL) to handle various forms of uncertainty such as random perturbations, rare events, and malicious attacks. In this work, we consider one critical type of robustness against spurious correlation, where different portions of the state do not have correlations induced by unobserved confounders. These spurious correlations are ubiquitous in real-world tasks, for instance, a self-driving car usually observes heavy traffic in the daytime and light traffic at night due to unobservable human activity. A model that learns such useless or even harmful correlation could catastrophically fail when the confounder in the test case deviates from the training one. Although motivated, enabling robustness against spurious correlation poses significant challenges since the uncertainty set, shaped by the unobserved confounder and causal structure, is difficult to characterize and identify. Existing robust algorithms that assume simple and unstructured uncertainty sets are therefore inadequate to address this challenge. To solve this issue, we propose Robust State-Confounded Markov Decision Processes (RSC-MDPs) and theoretically demonstrate its superiority in avoiding learning spurious correlations compared with other robust RL counterparts. We also design an empirical algorithm to learn the robust optimal policy for RSC-MDPs, which outperforms all baselines in eight realistic self-driving and manipulation tasks. Please refer to the website for more details.