提出DRIFT框架,让治疗效果预测更稳健,不依赖特定症状选择。
Maximin Learning of Individualized Treatment Effect on Multi-Domain Outcomes
- 用潜在因子和对抗学习从高维数据中提取稳定特征
- 在未测量领域上表现更好,外推能力更强
- 适合精神健康等多维度临床决策场景
精准心理健康需要考虑反映多个临床领域的异质性症状。然而,现有个体化治疗效应(ITE)估计方法依赖单一汇总结果或特定症状集合,对症状选择敏感,且难以推广到未测量的临床相关领域。我们提出DRIFT,一种基于潜在因子表示和对抗学习的新最大最小框架,用于从高维项目级数据中估计鲁棒的ITE。DRIFT通过广义因子分析学习潜在结构,构建锚定的目标不确定性集,以扩展至观测指标之外,逼近更广泛的潜在结果超总体。通过优化该不确定性集上的最差情况性能,DRIFT所得的ITE对欠代表或未测量领域具有鲁棒性。我们进一步证明DRIFT在潜在因子可接受重参数化下保持不变,并具有闭式最大最小解,具备识别与收敛性理论保证。在重度抑郁症随机对照试验(EMBARC)数据中的分析显示,DRIFT表现出色,对外部多维度结果(包括训练时未使用的副作用和自报症状)具有更强泛化能力。
原文摘要 · Abstract (English)
Precision mental health requires treatment decisions that account for heterogeneous symptoms reflecting multiple clinical domains. However, existing methods for estimating individualized treatment effects (ITE) rely on a single summary outcome or a specific set of observed symptoms or measures, which are sensitive to symptom selection and limit generalizability to unmeasured yet clinically relevant domains. We propose DRIFT, a new maximin framework for estimating robust ITEs from high-dimensional item-level data by leveraging latent factor representations and adversarial learning. DRIFT learns latent constructs via generalized factor analysis, then constructs an anchored on-target uncertainty set that extrapolates beyond the observed measures to approximate the broader hyper-population of potential outcomes. By optimizing worst-case performance over this uncertainty set, DRIFT yields ITEs that are robust to underrepresented or unmeasured domains. We further show that DRIFT is invariant to admissible reparameterizations of the latent factors and admits a closed-form maximin solution, with theoretical guarantees for identification and convergence. In analyses of a randomized controlled trial for major depressive disorder (EMBARC), DRIFT demonstrates superior performance and improved generalizability to external multi-domain outcomes, including side effects and self-reported symptoms not used during training.
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