Sinkhorn Treatment Effects: A Causal Optimal Transport Measure
Authors: Medha Agarwal, Alex Luedtke
Organizations: Department of Statistics, University of Washington, Seattle, WA, USA · Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
Abstract
We introduce the Sinkhorn treatment effect, an entropic optimal transport measure of divergence between counterfactual distributions. Unlike classical quantities such as the average treatment effect, this measure captures differences across entire distributions. We analyze this divergence as a statistical functional and show it can be written as a smooth transformation of counterfactual mean embeddings with an appropriate kernel. This characterization allows us to establish first-order pathwise differentiability in general, and second-order pathwise differentiability under the null hypothesis of equal counterfactual distributions. Leveraging this smoothness, we construct debiased estimators and use them to obtain asymptotically valid tests for distributional treatment effects with a fixed entropic regularization parameter. Because the power of the test depends on this unknown parameter, we further propose an aggregated test that combines evidence across a grid of regularization choices. Experiments on simulated and image data demonstrate the practical advantages of our estimator and testing procedure.
Distributional treatment effects can be invisible to means: a treatment may preserve average outcomes while changing tails, modes, dispersion, or rare-event probabilities. Kernel tests can detect discrepancies between interventional outcome laws, but global tests do not reveal where the laws differ. We propose DR-ME, to our knowledge the first semiparametrically efficient finite-location test for interpretable distributional treatment effects. DR-ME evaluates an interventional kernel witness at learned outcome locations, returning causal-discrepancy coordinates rather than only a global rejection. From observational data, we derive orthogonal doubly robust kernel features whose centered oracle form is the canonical gradient of this finite witness. For fixed locations, we characterize the local testing limit: DR-ME is chi-square calibrated under the null, has noncentral chi-square local power, and uses the covariance whitening that optimizes local signal-to-noise for discrepancies visible through the selected coordinates. This efficient local-power geometry yields a principled location-learning criterion, with sample splitting preserving post-selection validity. Experiments show near-nominal type-I error, competitive power against global doubly robust kernel tests, and interpretable learned locations that localize distributional effects in a semi-synthetic medical-imaging study.
Estimating counterfactual distributions under interventions is central to treatment risk assessment and counterfactual generation tasks. Existing approaches model the counterfactual distribution as a standalone generative target, without exploiting its relationship to the observational data. In this work, we show that under standard assumptions, observational and counterfactual outcome distributions are tightly linked: they have identical support and tail behavior, remain statistically close under weak confounding, and share any features of high-dimensional outcomes which are invariant to confounders. These properties motivate learning counterfactual distributions not from scratch, but via a deconfounding flow from the observational distribution. We formulate this problem via flow-matching and derive a semiparametrically efficient estimator based on a novel efficient influence function correction. We subsequently extend our estimator to target minimal-energy flows in high-dimensions, which we show can be especially simple targets between observational and counterfactual distributions. In experiments, deconfounding flows outperform existing debiased counterfactual distribution estimators, while also mitigating known failure modes of flow-based methods.
We study counterfactual regression, which maps features to outcomes under hypothetical scenarios that differ from those observed in the data. This problem is central to decision-making under distribution shift, where treatment patterns may change at deployment. We develop a semiparametric framework for counterfactual regression along a prespecified incremental-intervention path. The target is a finite-dimensional constrained projection of counterfactual risk, estimated using cross-fitted influence-function representations of the program components. For smooth programs with fixed constraints and finite-dimensional programs with estimated linear constraints, we establish consistency and local stability of the optimizer under class-specific conditions, and derive pointwise and uniform first-order expansions. These results yield asymptotically valid inference, including simultaneous confidence bands for the counterfactual regression path. Simulations and an application to SMS reminders illustrate the finite-sample performance and practical applicability of the proposed approach.