Quantifying causal effects from observed data using quasi-intervention

• Published in: BMC medical informatics and decision making Vol. 22; no. 1; pp. 337 - 11
• Main Authors: Yang, Jinghua, Wan, Yaping, Ni, Qianxi, Zuo, Jianhong, Wang, Jin, Zhang, Xiapeng, Zhou, Lifang
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 21.12.2022; BioMed Central; BMC
• Subjects: Algorithms; Analysis; Biomedical Research; Care and treatment; Causal effect; Causal inference; Causality; Cohort Studies; Diagnosis; Do-algorithm; Epidemiology; Health aspects; Humans; Intervention; Lung cancer; Methods; Probability; Quasi-experimental design; Quasi-intervention; Research Design; Treatment Outcome; China; Intervention; Causal effect; Quasi-intervention; Do-algorithm; Quasi-experimental design
• ISSN: 1472-6947; 1472-6947
• DOI: 10.1186/s12911-022-02086-z

Causal inference is a crucial element within medical decision-making. There have been many methods for investigating potential causal relationships between disease and treatment options developed in recent years, which can be categorized into two main types: observational studies and experimental studies. However, due to the nature of experimental studies, financial resources, human resources, and patients' ethical considerations, researchers cannot fully control the exposure of the research participants. Furthermore, most existing observational research designs are limited to determining causal relationships and cannot handle observational data, let alone determine the dosages needed for medical research. This paper presents a new experimental strategy called quasi-intervention for quantifying the causal effect between disease and treatment options in observed data by using a causal inference method, which converts the potential effect of different treatment options on disease into computing differences in the conditional probability. We evaluated the accuracy of the quasi-intervention by quantifying the impact of adjusting Chinese patients' neutrophil-to-lymphocyte ratio (NLR) on their overall survival (OS) (169 lung cancer patients and 79 controls).The results agree with the literature in this study, consisting of nine papers on cohort studies on the NLR and the prognosis of lung cancer patients, proving that our method is correct. Taken together, the results imply that quasi-intervention is a promising method for quantifying the causal effect between disease and treatment options without clinical trials, and it could improve confidence about treatment options' efficacy and safety.