Interpretable subgroup discovery in treatment effect estimation with application to opioid prescribing guidelines

Chirag Nagpal, Dennis Wei, B. Vinzamuri, Monica Shekhar, Sara E. Berger, Subhro Das, Kush R. Varshney
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引用次数: 17

Abstract

The dearth of prescribing guidelines for physicians is one key driver of the current opioid epidemic in the United States. In this work, we analyze medical and pharmaceutical claims data to draw insights on characteristics of patients who are more prone to adverse outcomes after an initial synthetic opioid prescription. Toward this end, we propose a generative model that allows discovery from observational data of subgroups that demonstrate an enhanced or diminished causal effect due to treatment. Our approach models these sub-populations as a mixture distribution, using sparsity to enhance interpretability, while jointly learning nonlinear predictors of the potential outcomes to better adjust for confounding. The approach leads to human interpretable insights on discovered subgroups, improving the practical utility for decision support.
阿片类药物处方指南中治疗效果评估的可解释亚群发现
医生处方指南的缺乏是目前美国阿片类药物流行的一个关键驱动因素。在这项工作中,我们分析了医疗和制药索赔数据,以了解在初始合成阿片类药物处方后更容易出现不良后果的患者的特征。为此,我们提出了一个生成模型,允许从亚组的观察数据中发现由于治疗而增强或减弱的因果效应。我们的方法将这些亚种群建模为混合分布,使用稀疏性来增强可解释性,同时共同学习潜在结果的非线性预测因子,以更好地调整混杂。该方法可以对发现的子组产生人类可解释的见解,从而提高决策支持的实际效用。
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