用因果模型构建个性化康复方案,提升长期功能恢复效果。
A Causal Framework for Precision Rehabilitation
- 基于因果推断构建患者恢复数字孪生模型,整合多源数据。
- 可识别最优动态治疗策略,显著提升长期功能改善率。
- 适合临床研究者与康复AI开发者参考应用。
精准康复有望通过循证方法优化个体化康复路径,改善长期功能结局。新兴技术,包括人工智能驱动的评估手段,正迅速提升我们对康复期间、医疗接触及社区生活中多种功能维度的量化能力。尽管这为康复医学带来大数据时代机遇,但当前领域仍缺乏有效框架来利用这些数据实现承诺。本文提出一个新框架,基于多个现有基础,旨在识别最优动态治疗方案(ODTR),即根据可用测量值和生物标志物选择最可能最大化长期功能的干预策略。该框架通过设计并拟合因果模型实现,扩展了计算神经康复框架,采用因果推断工具。模型能学习来自不同数据孤岛的异构数据,需包含详细的干预记录(如使用康复治疗规范系统)。这些模型作为患者恢复轨迹的数字孪生体,用于学习最优治疗方案。框架还强调在功能不同层面变化间的定量关联,确保干预既基于精细的损伤测量,又聚焦于对患者和利益相关者有意义的结局。我们认为此方法可成为整合日益增长的康复大数据与智能测量技术的统一框架,推动精准康复治疗,改善临床结果。
原文摘要 · Abstract (English)
Precision rehabilitation offers the promise of an evidence-based approach for optimizing individual rehabilitation to improve long-term functional outcomes. Emerging techniques, including those driven by artificial intelligence, are rapidly expanding our ability to quantify the different domains of function during rehabilitation, other encounters with healthcare, and in the community. While this seems poised to usher rehabilitation into the era of big data and should be a powerful driver of precision rehabilitation, our field lacks a coherent framework to utilize these data and deliver on this promise. We propose a framework that builds upon multiple existing pillars to fill this gap. Our framework aims to identify the Optimal Dynamic Treatment Regimens (ODTR), or the decision-making strategy that takes in the range of available measurements and biomarkers to identify interventions likely to maximize long-term function. This is achieved by designing and fitting causal models, which extend the Computational Neurorehabilitation framework using tools from causal inference. These causal models can learn from heterogeneous data from different silos, which must include detailed documentation of interventions, such as using the Rehabilitation Treatment Specification System. The models then serve as digital twins of patient recovery trajectories, which can be used to learn the ODTR. Our causal modeling framework also emphasizes quantitatively linking changes across levels of the functioning to ensure that interventions can be precisely selected based on careful measurement of impairments while also being selected to maximize outcomes that are meaningful to patients and stakeholders. We believe this approach can provide a unifying framework to leverage growing big rehabilitation data and AI-powered measurements to produce precision rehabilitation treatments that can improve clinical outcomes.
Thank you to arXiv for use of its open access interoperability. PaperDance 不是 arXiv 官方产品;中文卡片由大模型生成,请以原文为准。