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Causal AI with Real World Data: Do Statins Protect from Alzheimer's Disease Onset?

Published: 26 October 2021 Publication History

Abstract

Causal artificial intelligence aims at developing bias-robust models that can be used to intervene on, rather than just be predictive, of risks or outcomes. However, learning interventional models from observational data, including electronic health records (EHR), is challenging due to inherent bias, e.g., protopathic, confounding, collider. When estimating the effects of treatment interventions, classical approaches like propensity score matching are often used, but they pose limitations with large feature sets, nonlinear/nonparallel treatment group assignments, and collider bias. In this work, we used data from a large EHR consortium –OneFlorida– and evaluated causal statistical/machine learning methods for determining the effect of statin treatment on the risk of Alzheimer's disease, a debated clinical research question. We introduced a combination of directed acyclic graph (DAG) learning and comparison with expert's design, with calculation of the generalized adjustment criterion (GAC), to find an optimal set of covariates for estimation of treatment effects –ameliorating collider bias. The DAG/CAC approach was assessed together with traditional propensity score matching, inverse probability weighting, virtual-twin/counterfactual random forests, and deep counterfactual networks. We showed large heterogeneity in effect estimates upon different model configurations. Our results did not exclude a protective effect of statins, where the DAG/GAC point estimate aligned with the maximum credibility estimate, although the 95% credibility interval included a null effect, warranting further studies and replication.

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  • (2023)Artificial intelligence for dementia preventionAlzheimer's & Dementia10.1002/alz.1346319:12(5952-5969)Online publication date: 14-Oct-2023

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ICMHI '21: Proceedings of the 5th International Conference on Medical and Health Informatics
May 2021
347 pages
ISBN:9781450389846
DOI:10.1145/3472813
Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for components of this work owned by others than ACM must be honored. Abstracting with credit is permitted. To copy otherwise, or republish, to post on servers or to redistribute to lists, requires prior specific permission and/or a fee. Request permissions from [email protected]

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Association for Computing Machinery

New York, NY, United States

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Published: 26 October 2021

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Author Tags

  1. Bayesian network
  2. Causal artificial intelligence
  3. biomedical informatics
  4. directed acyclic graph
  5. electronic medical records
  6. generalized adjustment criterion
  7. machine learning
  8. treatment effect

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  • (2023)Artificial intelligence for dementia preventionAlzheimer's & Dementia10.1002/alz.1346319:12(5952-5969)Online publication date: 14-Oct-2023

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