Estimating the Impact of Pre-Exposure Prophylaxis (PrEP) on Mortality in COVID-19 Patients: A Causal Inference Approach

Author:

Subramanian Ajan,Huang Yong,Pinto Melissa D.,Downs Charles A.,Rahmani Amir M.ORCID

Abstract

AbstractTraditional machine learning (ML) approaches learn to recognize patterns in the data but fail to go beyond observing associations. Such data-driven methods can lack generalizability when the data is outside the independent and identically distributed (i.i.d) setting. Using causal inference can aid data-driven techniques to go beyond learning spurious associations and frame the data-generating process in a causal lens. We can combine domain expertise and traditional ML techniques to answer causal questions on the data. Hypothetical questions on alternate realities can also be answered with such a framework. In this paper, we estimate the causal effect of Pre-Exposure Prophylaxis (PrEP) on mortality in COVID-19 patients from an observational dataset of over 120,000 patients. With the help of medical experts, we hypothesize a causal graph that identifies the causal and non-causal associations, including the list of potential confounding variables. We use estimation techniques such as linear regression, matching, and machine learning (meta-learners) to estimate the causal effect. On average, our estimates show that taking PrEP can result in a 2.1% decrease in the death rate or a total of around 2,540 patients’ lives saved in the studied population.

Publisher

Cold Spring Harbor Laboratory

Reference19 articles.

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5. J. Kaddour , A. Lynch , Q. Liu , M. J. Kusner , and R. Silva , “Causal machine learning: A survey and open problems,” arXiv preprint arXiv:2206.15475, 2022.

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