Causal Effect Estimation on Imaging and Clinical Data for Treatment Decision Support of Aneurysmal Subarachnoid Hemorrhage

Abstract

Aneurysmal subarachnoid hemorrhage is a medical emergency of brain that has high mortality and poor prognosis. Causal effect estimation of treatment strategies on patient outcomes is crucial for aneurysmal subarachnoid hemorrhage treatment decision-making. However, most existing studies on treatment decision-making support of this disease are unable to simultaneously compare the potential outcomes of different treatments for a patient. Furthermore, these studies fail to harmoniously integrate the imaging data with non-imaging clinical data, both of which are useful in clinical scenarios. In this paper, we estimate the causal effect of various treatments on patients with aneurysmal subarachnoid hemorrhage by integrating plain CT with non-imaging clinical data, which is represented using structured tabular data. Specifically, we first propose a novel scheme that uses multi-modality confounders distillation architecture to predict the treatment outcome and treatment assignment simultaneously. With these distilled confounder features, we design an imaging and non-imaging interaction representation learning strategy to use the complementary information extracted from different modalities to balance the feature distribution of different treatment groups. We have conducted extensive experiments using a clinical dataset of 656 subarachnoid hemorrhage cases, which was collected from the Hospital Authority Data Collaboration Laboratory in Hong Kong. Our method shows consistent improvements on the evaluation metrics of treatment effect estimation, achieving state-of-the-art results over strong competitors. Code is released at https://github.com/med-air/TOP-aSAH.