Resolving the bias-precision paradox with stochastic causal representation learning for personalized medicine

Estimating counterfactual outcomes over time from longitudinal observational data is central to clinical decision support. Existing methods rely on domain confusion -- adversarial training that renders representations invariant to treatment assignment -- yet this invariance creates a mutual information conflict: it suppresses treatment-correlated covariate signals necessary for accurate outcome prediction. We formalise this tension via a Jensen-Shannon divergence bound on counterfactual prediction error and develop two complementary models. CSSD (Causal State-Space model with Direct decoder) adapts selective State Space Models with a parallel multi-step decoder that eliminates accumulated rollout error by producing all prediction horizons simultaneously in a single forward pass. CSSPD (Causal State-Space model with Predictive regularisation and Direct decoder) augments CSSD with Contrastive Predictive Coding and Local Information Maximisation to reinforce temporal predictability in the balancing representation and recover local covariate information destroyed by domain confusion. On MIMIC-III, CSSPD achieves lower counterfactual RMSE than the Causal Transformer at every horizon tau >= 2 at O(T) encoder cost, with gains from 0.02 (2-step) to 0.07 (6-step). On Cancer Simulation across confounding strengths gamma in {0,1,2,3,4}, CSSPD outperforms CT at gamma <= 3 (margins 25.9%--37.0%), and CSSD achieves the lowest overall average RMSE (12.7% reduction over CT), confirming the MI conflict analysis. To our knowledge, this is the first work to formalise the balancing-prediction MI conflict and propose a structured resolution through complementary predictive and information-theoretic training objectives.

In various fields, such as medicine and marketing, accurately predicting individual treatment effects holds significant promise. However, achieving reliable predictions alone is often insufficient for making informed decisions; it is equally important to understand why the treatment effect is higher for some individuals than for others. To address this two-fold challenge of prediction and interpretation, we introduce an algorithm based on decision trees and random forests for estimating individual treatment effects. Our algorithm is simple: it operates exactly like a standard random forest, but with a different splitting criterion, and requires no additional workarounds such as double machine learning or orthogonalization as used in Generalized random forests. It handles observational studies with varying treatment propensities without requiring separate estimation of the full propensity function. This is achieved by combining two splitting criteria---one targeting heterogeneity in the treatment effect, the other targeting bias correction for the average treatment effect---which together improve split point selection and automatically distinguish confounders from features responsible for heterogeneity. As a result, interpretation follows directly from the fitted tree structure itself, that is, from which features the trees split on and with which split statistics, without requiring separate post-hoc analysis. For the theoretical analysis of this algorithm, we consider a change point model with step functions for potential outcomes and treatment propensity and provide insights into the theoretical underpinnings of our approach. Simulation studies show that our simple algorithm achieves comparable, and often better, prediction accuracy than existing methods, while substantially improving interpretability.

Predictive machine learning (ML) models are increasingly used to aid human decision-makers across various high-risk domains such as healthcare and criminal justice. There is a growing recognition of the need to evaluate the causal impact of deploying these systems on downstream outcomes, such as patient survival or crime recidivism. Randomized control trials (RCTs) can provide high-quality evidence on the impact of a deployed model, but they run into a challenge: it is often infeasible to run repeated trials when models are updated or retrained to improve predictive performance. In this work, we present a partial-identification approach to using prior RCT data to construct bounds on the causal effect of a new model. The core innovation in our approach is to leverage assumptions relating fine-grained predictive accuracy to downstream outcomes. We do so via two monotonicity assumptions: first, on individual-level `counterfactual correctness' (all else being equal, a correct prediction leads to non-inferior outcomes); and second, on the relation between subgroup predictive performance and outcomes, interpretable as an assumption regarding trust in model outputs. We demonstrate our method with a simulation study, illustrating how incorporating this information can lead to more informative bounds compared to prior work.