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Register a new userBeyond Scalar Treatment: A Causal Analysis of Hippocampal Atrophy on Behavioral Deficits in Alzheimers Studies
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Dehan Kong
Publication date
2020
fields
Mathematical Statistics
and research's language is
English
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Alzheimers disease is a progressive form of dementia that results in problems with memory, thinking and behavior. It often starts with abnormal aggregation and deposition of beta-amyloid and tau, followed by neuronal damage such as atrophy of the hippocampi, and finally leads to behavioral deficits. Despite significant progress in finding biomarkers associated with behavioral deficits, the underlying causal mechanism remains largely unknown. Here we investigate whether and how hippocampal atrophy contributes to behavioral deficits based on a large-scale observational study conducted by the Alzheimers Disease Neuroimaging Initiative (ADNI). As a key novelty, we use 2D representations of the hippocampi, which allows us to better understand atrophy associated with different subregions. It, however, introduces methodological challenges as existing causal inference methods are not well suited for exploiting structural information embedded in the 2D exposures. Moreover, our data contain more than 6 million clinical and genetic covariates, necessitating appropriate confounder selection methods. We hence develop a novel two-step causal inference approach tailored for our ADNI data application. Analysis results suggest that atrophy of CA1 and subiculum subregions may cause more severe behavioral deficits compared to CA2 and CA3 subregions. We further evaluate our method using simulations and provide theoretical guarantees.
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Causal mediation analysis is used to evaluate direct and indirect causal effects of a treatment on an outcome of interest through an intermediate variable or a mediator.It is difficult to identify the direct and indirect causal effects because the mediator cannot be randomly assigned in many real applications. In this article, we consider a causal model including latent confounders between the mediator and the outcome. We present sufficient conditions for identifying the direct and indirect effects and propose an approach for estimating them. The performance of the proposed approach is evaluated by simulation studies. Finally, we apply the approach to a data set of the customer loyalty survey by a telecom company.
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In the process of clinical diagnosis and treatment, the restricted mean survival time (RMST), which reflects the life expectancy of patients up to a specified time, can be used as an appropriate outcome measure. However, the RMST only calculates the mean survival time of patients within a period of time after the start of follow-up and may not accurately portray the change in a patients life expectancy over time. The life expectancy can be adjusted for the time the patient has already survived and defined as the conditional restricted mean survival time (cRMST). A dynamic RMST model based on the cRMST can be established by incorporating time-dependent covariates and covariates with time-varying effects. We analysed data from a study of primary biliary cirrhosis (PBC) to illustrate the use of the dynamic RMST model. The predictive performance was evaluated using the C-index and the prediction error. The proposed dynamic RMST model, which can explore the dynamic effects of prognostic factors on survival time, has better predictive performance than the RMST model. Three PBC patient examples were used to illustrate how the predicted cRMST changed at different prediction times during follow-up. The use of the dynamic RMST model based on the cRMST allows for optimization of evidence-based decision-making by updating personalized dynamic life expectancy for patients.
No unmeasured confounding is often assumed in estimating treatment effects in observational data when using approaches such as propensity scores and inverse probability weighting. However, in many such studies due to the limitation of the databases, collected confounders are not exhaustive, and it is crucial to examine the extent to which the resulting estimate is sensitive to the unmeasured confounders. We consider this problem for survival and competing risks data. Due to the complexity of models for such data, we adapt the simulated potential confounders approach of Carnegie et al. (2016), which provides a general tool for sensitivity analysis due to unmeasured confounding. More specifically, we specify one sensitivity parameter to quantify the association between an unmeasured confounder and the treatment assignment, and another set of parameters to quantify the association between the confounder and the time-to-event outcomes. By varying the magnitudes of the sensitivity parameters, we estimate the treatment effect of interest using the stochastic EM and the EM algorithms. We demonstrate the performance of our methods on simulated data, and apply them to a comparative effectiveness study in inflammatory bowel disease (IBD).
Spatial prediction of weather-elements like temperature, precipitation, and barometric pressure are generally based on satellite imagery or data collected at ground-stations. None of these data provide information at a more granular or hyper-local resolution. On the other hand, crowdsourced weather data, which are captured by sensors installed on mobile devices and gathered by weather-related mobile apps like WeatherSignal and AccuWeather, can serve as potential data sources for analyzing environmental processes at a hyper-local resolution. However, due to the low quality of the sensors and the non-laboratory environment, the quality of the observations in crowdsourced data is compromised. This paper describes methods to improve hyper-local spatial prediction using this varying-quality noisy crowdsourced information. We introduce a reliability metric, namely Veracity Score (VS), to assess the quality of the crowdsourced observations using a coarser, but high-quality, reference data. A VS-based methodology to analyze noisy spatial data is proposed and evaluated through extensive simulations. The merits of the proposed approach are illustrated through case studies analyzing crowdsourced daily average ambient temperature readings for one day in the contiguous United States.
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