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Record W2911416111 · doi:10.1136/bmjebm-2018-111069

Causal inference for clinicians

2019· article· en· W2911416111 on OpenAlexaff
Steven D. Stovitz, Ian Shrier

Bibliographic record

VenueBMJ evidence-based medicine · 2019
Typearticle
Languageen
FieldMathematics
TopicAdvanced Causal Inference Techniques
Canadian institutionsJewish General Hospital
Fundersnot available
KeywordsInferenceCausal inferencePsychologyComputer scienceArtificial intelligenceEconometricsMathematics

Abstract

fetched live from OpenAlex

Evidence-based medicine (EBM) calls on clinicians to incorporate the 'best available evidence' into clinical decision-making. For decisions regarding treatment, the best evidence is that which determines the causal effect of treatments on the clinical outcomes of interest. Unfortunately, research often provides evidence where associations are not due to cause-and-effect, but rather due to non-causal reasons. These non-causal associations may provide valid evidence for diagnosis or prognosis, but biased evidence for treatment effects. Causal inference aims to determine when we can infer that associations are or are not due to causal effects. Since recommending treatments that do not have beneficial causal effects will not improve health, causal inference can advance the practice of EBM. The purpose of this article is to familiarise clinicians with some of the concepts and terminology that are being used in the field of causal inference, including graphical diagrams known as 'causal directed acyclic graphs'. In order to demonstrate some of the links between causal inference methods and clinical treatment decision-making, we use a clinical vignette of assessing treatments to lower cardiovascular risk. As the field of causal inference advances, clinicians familiar with the methods and terminology will be able to improve their adherence to the principles of EBM by distinguishing causal effects of treatment from results due to non-causal associations that may be a source of bias.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Direct model labels (unvalidated)

Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.

Model armCategoriesStudy designConfidence
gemmano category
Domain: not available · Genre: Methods
About the Canadian research system: no · About a Canadian topic: no
Not applicablelow
gptno category
Domain: not available · Genre: Methods
About the Canadian research system: no · About a Canadian topic: no
Theoretical or conceptuallow
models splitAgreement compares identical category sets and study designs across arms.

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.096
metaresearch head score (Gemma)0.330
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Methods · Consensus signal: Methods
Teacher disagreement score0.096
Threshold uncertainty score0.508

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0960.330
Meta-epidemiology (narrow)0.0020.002
Meta-epidemiology (broad)0.0030.003
Bibliometrics0.0060.004
Science and technology studies0.0030.013
Scholarly communication0.0090.012
Open science0.0050.006
Research integrity0.0090.017
Insufficient payload (model declined to judge)0.0310.007

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.383
GPT teacher head0.537
Teacher spread0.154 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Labeled directly by 2 models reading the full record.

The models applied no category: nothing in the taxonomy fit this work.

The models disagree on parts of this classification; every voice is preserved in the section at the end of the page.

Study designNot applicable · Theoretical or conceptual
Domainnot available
GenreMethods

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations34
Published2019
Admission routes1
Has abstractyes

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