An Interpretable Framework to Identify Responsive Subgroups From Clinical Trials Regarding Treatment Effects: Application to Treatment of Intracerebral Hemorrhage

Authors

Yaobin Ling
Muhammad Bilal Tariq
Kaichen Tang
Jaroslaw Aronowski
Yang Fann
Sean I Savitz
Xiaoqian Jiang
Yejin Kim

Publication Date

5-1-2024

Journal

PLOS Digital Health

Abstract

Randomized Clinical trials (RCT) suffer from a high failure rate which could be caused by heterogeneous responses to treatment. Despite many models being developed to estimate heterogeneous treatment effects (HTE), there remains a lack of interpretable methods to identify responsive subgroups. This work aims to develop a framework to identify subgroups based on treatment effects that prioritize model interpretability. The proposed framework leverages an ensemble uplift tree method to generate descriptive decision rules that separate samples given estimated responses to the treatment. Subsequently, we select a complementary set of these decision rules and rank them using a sparse linear model. To address the trial's limited sample size problem, we proposed a data augmentation strategy by borrowing control patients from external studies and generating synthetic data. We apply the proposed framework to a failed randomized clinical trial for investigating an intracerebral hemorrhage therapy plan. The Qini-scores show that the proposed data augmentation strategy plan can boost the model's performance and the framework achieves greater interpretability by selecting complementary descriptive rules without compromising estimation quality. Our model derives clinically meaningful subgroups. Specifically, we find those patients with Diastolic Blood Pressure≥70 mm hg and Systolic Blood Pressuresubgroups, our framework can contribute to developing personalized treatment strategies for patients more efficiently.

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Supplementary Materials

PMID: 38713647