arXiv subjects

Zachary Shahn

Publications and source records attributed to Zachary Shahn.

3 recordsLinked to original sources

arXiv2024

Causal inference for N-of-1 trials

The aim of personalized medicine is to tailor treatment decisions to individuals' characteristics. N-of-1 trials are within-person crossover trials that hold the promise of targeting individual-specific effects. While the idea behind N-of-1 trials might seem simple, analyzing and interpreting N-of-1 trials is not straightforward. Here we ground N-of-1 trials in a formal causal inference framework and formalize intuitive claims from the N-of-1 trials literature. We focus on causal inference from a single N-of-1 trial and define a conditional average treatment effect (CATE) that represents a target in this setting, which we call the U-CATE. We discuss assumptions sufficient for identification and estimation of the U-CATE under different causal models where the treatment schedule is assigned at baseline. A simple mean difference is an unbiased, asymptotically normal estimator of the U-CATE in simple settings. We also consider settings where carryover effects, trends over time, time-varying common causes of the outcome, and outcome-outcome effects are present. In these more complex settings, we show that a time-varying g-formula identifies the U-CATE under explicit assumptions. Finally, we analyze data from N-of-1 trials about acne symptoms and show how different assumptions about the data generating process can lead to different analytical strategies.

stat.ME↗

arXiv2022

Using negative controls to identify causal effects with invalid instrumental variables

Many proposals for the identification of causal effects require an instrumental variable that satisfies strong, untestable unconfoundedness and exclusion restriction assumptions. In this paper, we show how one can potentially identify causal effects under violations of these assumptions by harnessing a negative control population or outcome. This strategy allows one to leverage sub-populations for whom the exposure is degenerate, and requires that the instrument-outcome association satisfies a certain parallel trend condition. We develop the semiparametric efficiency theory for a general instrumental variable model, and obtain a multiply robust, locally efficient estimator of the average treatment effect in the treated. The utility of the estimators is demonstrated in simulation studies and an analysis of the Life Span Study.

stat.ME↗

arXiv2020

Is Deep Reinforcement Learning Ready for Practical Applications in Healthcare? A Sensitivity Analysis of Duel-DDQN for Hemodynamic Management in Sepsis Patients

The potential of Reinforcement Learning (RL) has been demonstrated through successful applications to games such as Go and Atari. However, while it is straightforward to evaluate the performance of an RL algorithm in a game setting by simply using it to play the game, evaluation is a major challenge in clinical settings where it could be unsafe to follow RL policies in practice. Thus, understanding sensitivity of RL policies to the host of decisions made during implementation is an important step toward building the type of trust in RL required for eventual clinical uptake. In this work, we perform a sensitivity analysis on a state-of-the-art RL algorithm (Dueling Double Deep Q-Networks)applied to hemodynamic stabilization treatment strategies for septic patients in the ICU. We consider sensitivity of learned policies to input features, embedding model architecture, time discretization, reward function, and random seeds. We find that varying these settings can significantly impact learned policies, which suggests a need for caution when interpreting RL agent output.

cs.LG↗