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arXiv 2023年

作者： Luijken, Kim Morzywolek, Pawel van Amsterdam, Wouter Cinà, Giovanni Hoogland, Jeroen Keogh, Ruth Krijthe, Jesse Magliacane, Sara van Ommen, Thijs Peek, Niels Putter, Hein van Smeden, Maarten Sperrin, Matthew Wang, Junfeng Weir, Daniala Didelez, Vanessa van Geloven, Nan Department of Epidemiology Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht Netherlands Department of Applied Mathematics Computer Science and Statistics Ghent University Ghent Belgium Department of Statistics University of Washington Seattle United States Department of Medical Informatics Amsterdam University Medical Centers Amsterdam Netherlands Institute for Logic Language and Computation University of Amsterdam Amsterdam Netherlands Pacmed Amsterdam Netherlands Department of Epidemiology and Data Science Amsterdam University Medical Centers Amsterdam Netherlands Department of Medical Statistics London School of Hygiene & Tropical Medicine Keppel Street London United Kingdom Pattern Recognition and Bio-Informatics Group EEMCS Delft University of Technology Delft Netherlands Amsterdam Machine Learning Lab University of Amsterdam Amsterdam Netherlands Department of Information and Computing Sciences Utrecht University Utrecht Netherlands Division of Informatics Imaging and Data Science Faculty of Biology Medicine and Health University of Manchester Manchester Academic Health Science Centre Manchester United Kingdom Department of Biomedical Data Sciences Leiden University Medical Center Leiden Netherlands Division of Pharmacoepidemiology and Clinical Pharmacology Department of Pharmaceutical Sciences Utrecht University Utrecht Netherlands Department of Biometry and Data Management Leibniz Institute for Prevention Research Epidemiology - BIPS Bremen Germany Faculty of Mathematics/Computer Science University of Bremen Bremen Germany

Prediction models are used amongst others to inform medical decisions on interventions. Typically, individuals with high risks of adverse outcomes are advised to undergo an intervention while those at low risk are advised to refrain from it. Standard prediction models do not always provide risks that are relevant to inform such decisions: e.g., an individual may be estimated to be at low risk because similar individuals in the past received an intervention which lowered their risk. Therefore, prediction models supporting decisions should target risks belonging to defined intervention strategies. Previous works on prediction under interventions assumed that the prediction model was used only at one time point to make an intervention decision. In clinical practice, intervention decisions are rarely made only once: they might be repeated, deferred and re-evaluated. This requires estimated risks under interventions that can be reconsidered at several potential decision moments. In the current work, we highlight key considerations for formulating estimands in sequential prediction under interventions that can inform such intervention decisions. We illustrate these considerations by giving examples of estimands for a case study about choosing between vaginal delivery and cesarean section for women giving birth. Our formalization of prediction tasks in a sequential, causal, and estimand context provides guidance for future studies to ensure that the right question is answered and appropriate causal estimation approaches are chosen to develop sequential prediction models that can inform intervention decisions. © 2023, CC BY.

关键词： Forecasting

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