Improving the accuracy of medical diagnosis with causal machine learning

Machine learning promises to revolutionize clinical decision making and diagnosis. In medical diagnosis a doctor aims to explain a patient’s symptoms by determining the diseases causing them. However, existing machine learning approaches to diagnosis are purely associative, identifying diseases that...

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Veröffentlicht in:Nature communications 2020-08, Vol.11 (1), p.3923-9, Article 3923
Hauptverfasser: Richens, Jonathan G., Lee, Ciarán M., Johri, Saurabh
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Sprache:eng
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Zusammenfassung:Machine learning promises to revolutionize clinical decision making and diagnosis. In medical diagnosis a doctor aims to explain a patient’s symptoms by determining the diseases causing them. However, existing machine learning approaches to diagnosis are purely associative, identifying diseases that are strongly correlated with a patients symptoms. We show that this inability to disentangle correlation from causation can result in sub-optimal or dangerous diagnoses. To overcome this, we reformulate diagnosis as a counterfactual inference task and derive counterfactual diagnostic algorithms. We compare our counterfactual algorithms to the standard associative algorithm and 44 doctors using a test set of clinical vignettes. While the associative algorithm achieves an accuracy placing in the top 48% of doctors in our cohort, our counterfactual algorithm places in the top 25% of doctors, achieving expert clinical accuracy. Our results show that causal reasoning is a vital missing ingredient for applying machine learning to medical diagnosis. In medical diagnosis a doctor aims to explain a patient’s symptoms by determining the diseases causing them, while existing diagnostic algorithms are purely associative. Here, the authors reformulate diagnosis as a counterfactual inference task and derive new counterfactual diagnostic algorithms.
ISSN:2041-1723
2041-1723
DOI:10.1038/s41467-020-17419-7