用因果知识图谱分析药物副作用,发现新风险并验证其临床相关性。
Causal knowledge graph analysis identifies adverse drug effects
- 构建药物-疾病因果知识图谱,融合医学路径与因果推理机制。
- 在英国生物样本库和MIMIC-IV数据中识别出已知及未知的药物副作用。
- 结果可指导临床用药,适合药理学与医疗数据分析研究者使用。
知识图谱与结构因果模型各自在组织生物医学知识和估计因果效应方面具有价值,但彼此脱节:知识图谱侧重事实与演绎推理,缺乏概率语义;而因果模型则无法接入知识图谱中的背景知识,也丧失了其演绎能力。为此,我们提出一种新型因果知识图谱(CKGs),在保持原有演绎能力的同时引入正式因果语义,支持通过显式标记的因果边进行去混杂,并促进与编码和推导出的背景知识一致的假设生成。我们构建了药物-疾病因果知识图谱(DD-CKG),整合疾病进展路径、药物适应症、不良反应及疾病层级分类,实现自动化大规模中介分析。在英国生物样本库(UK Biobank)和MIMIC-IV队列上的应用表明,该方法在调整由DD-CKG推断出的混杂因素后,成功以高精度复现已知不良反应,并识别出此前未记录的显著候选副作用。进一步通过副作用相似性分析验证,将预测结果与现有数据库结合,显著提升对共享药物适应症的预测能力,证实新发现具有临床意义。结果表明,本方法为可扩展的、基于知识驱动的因果推断提供了通用框架。
原文摘要 · Abstract (English)
Knowledge graphs and structural causal models have each proven valuable for organizing biomedical knowledge and estimating causal effects, but remain largely disconnected: knowledge graphs encode qualitative relationships focusing on facts and deductive reasoning without formal probabilistic semantics, while causal models lack integration with background knowledge in knowledge graphs and have no access to the deductive reasoning capabilities that knowledge graphs provide. To bridge this gap, we introduce a novel formulation of Causal Knowledge Graphs (CKGs) which extend knowledge graphs with formal causal semantics, preserving their deductive capabilities while enabling principled causal inference. CKGs support deconfounding via explicitly marked causal edges and facilitate hypothesis formulation aligned with both encoded and entailed background knowledge. We constructed a Drug-Disease CKG (DD-CKG) integrating disease progression pathways, drug indications, side-effects, and hierarchical disease classification to enable automated large-scale mediation analysis. Applied to UK Biobank and MIMIC-IV cohorts, we tested whether drugs mediate effects between indications and downstream disease progression, adjusting for confounders inferred from the DD-CKG. Our approach successfully reproduced known adverse drug reactions with high precision while identifying previously undocumented significant candidate adverse effects. Further validation through side effect similarity analysis demonstrated that combining our predicted drug effects with established databases significantly improves the prediction of shared drug indications, supporting the clinical relevance of our novel findings. These results demonstrate that our methodology provides a generalizable, knowledge-driven framework for scalable causal inference.
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