A Machine-Learning Approach for Estimating Subgroup- and Individual-Level Treatment Effects: An Illustration Using the 65 Trial.
Sadique, Zia;
Grieve, Richard;
Diaz-Ordaz, Karla;
Mouncey, Paul;
Lamontagne, Francois;
O'Neill, Stephen;
(2022)
A Machine-Learning Approach for Estimating Subgroup- and Individual-Level Treatment Effects: An Illustration Using the 65 Trial.
Medical decision making : an international journal of the Society for Medical Decision Making, 42 (7).
pp. 923-936.
ISSN 0272-989X
DOI: https://doi.org/10.1177/0272989X221100717
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This article examines a causal machine-learning approach, causal forests (CF), for exploring the heterogeneity of treatment effects, without prespecifying a specific functional form.The CF approach is considered in the reanalysis of the 65 Trial and was found to provide similar estimates of subgroup effects to using a fixed parametric model.The CF approach also provides estimates of individual-level treatment effects that suggest that for most patients in the 65 Trial, the intervention is expected to reduce 90-d mortality but with wide levels of statistical uncertainty.The study illustrates how individual-level treatment effect estimates can be analyzed to generate hypotheses for further research about those patients who are likely to benefit most from an intervention.