G-Transformer: Counterfactual Outcome Prediction under Dynamic and Time-varying Treatment Regimes

• URL: http://arxiv.org/abs/2406.05504v4
• Date: Thu, 26 Sep 2024 00:00:34 GMT
• Title: G-Transformer: Counterfactual Outcome Prediction under Dynamic and Time-varying Treatment Regimes
• Authors: Hong Xiong, Feng Wu, Leon Deng, Megan Su, Li-wei H Lehman,
• Abstract summary: We present G-Transformer for counterfactual outcome prediction under dynamic and time-varying treatment strategies. Our approach leverages a Transformer architecture to capture complex, long-range dependencies in time-varying covariates. G-Transformer outperforms both classical and state-of-the-art counterfactual prediction models in these settings.
• Score: 29.250837221920925
• License: http://arxiv.org/licenses/nonexclusive-distrib/1.0/
• Abstract: In the context of medical decision making, counterfactual prediction enables clinicians to predict treatment outcomes of interest under alternative courses of therapeutic actions given observed patient history. In this work, we present G-Transformer for counterfactual outcome prediction under dynamic and time-varying treatment strategies. Our approach leverages a Transformer architecture to capture complex, long-range dependencies in time-varying covariates while enabling g-computation, a causal inference method for estimating the effects of dynamic treatment regimes. Specifically, we use a Transformer-based encoder architecture to estimate the conditional distribution of relevant covariates given covariate and treatment history at each time point, then produces Monte Carlo estimates of counterfactual outcomes by simulating forward patient trajectories under treatment strategies of interest. We evaluate G-Transformer extensively using two simulated longitudinal datasets from mechanistic models, and a real-world sepsis ICU dataset from MIMIC-IV. G-Transformer outperforms both classical and state-of-the-art counterfactual prediction models in these settings. To the best of our knowledge, this is the first Transformer-based architecture that supports g-computation for counterfactual outcome prediction under dynamic and time-varying treatment strategies.

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