We developed a unified covariate-adjusted causal inference framework for estimating the desirability of outcome ranking (DOOR) probability for benefit-risk evaluation in randomized trials and observational studies. The framework expresses the DOOR probability as a bilinear functional of the marginal ordinal outcome distributions under the two treatment strategies, estimates conditional ordinal distributions through sequential risk-set hazards, and derives the efficient influence function (EIF) of the DOOR probability. The point-estimation simulations compared G-computation, normalized inverse probability weighting (IPW), augmented IPW (AIPW), and targeted maximum likelihood estimation (TMLE), with nuisance functions estimated using generalized linear models or Super Learner (SL). TMLE-SL showed the strongest and most consistent point-estimation performance, with AIPW-SL ranking second. EIF-based inference was then evaluated for AIPW-SL and TMLE-SL, with and without cross-fitting, across settings varying in overlap, treatment-effect heterogeneity, and treatment allocation. CVTMLE-SL showed the strongest overall performance across DOOR-scale bias, recovery of the underlying ordinal distributions, standard-error accuracy, and confidence-interval coverage. We illustrate the methodology using data from the multidrug-resistant organism network of the Antibacterial Resistance Leadership Group.
We introduce causal density functions: Radon-Nikodym derivatives that compare interventional laws to observational laws and therefore act as local density ratios for causal effects. Whereas many causal-strength measures compare whole distributions after graph surgery, causal density functions provide a pointwise change-of-measure object that can be estimated, calibrated, and used to score directed influence. The basic identity
Edo[f(Y)]=Eobs[f(Y)ρ(X,Y)]
makes causal density directly testable: if the estimated density ratio is correct, observational expectations reweighted by ρ reproduce interventional expectations. We derive practical estimators for do-curves and directed edge scores, relate the construction to Radon-Nikodym/Kan semantics for conditioning and intervention, and evaluate the resulting estimators on synthetic and real perturbation benchmarks.
When treatment effects are naturally expressed as ratios -- as in medicine, pricing, and marketing -- the ratio-based CATE τ(x)=E[Y∣W=1,X=x]/E[Y∣W=0,X=x] is the appropriate estimand. Yet existing estimators either impose a log-linear parametric structure or apply generic regression without robustness guarantees for this functional. We introduce the Q-Learner, which decomposes τ(x) into a product of two odds ratios, reducing ratio-CATE estimation for binary outcomes to two propensity classification tasks. We further derive doubly robust augmentations for both S/T- and Q-style ratio learners and characterize their distinct robustness properties. In benchmarks on seven RCT datasets, the Q-Learner is the most consistently competitive method in low-conversion regimes, where its propensity-only construction sidesteps the imbalanced regression that hurts outcome-based estimators. On four observational datasets, where propensity must be estimated and confounding cannot be ruled out, the DR learners introduced here decisively come out on top, making them practitioners' natural default for confounded observational data.
Probabilistic models are typically trained using task-agnostic objectives like log-loss, which can lead to significant errors in downstream estimation. This disconnect is especially critical in Inverse Probability Weighting (IPW) for causal inference, where propensity score errors near 0 and 1 often lead to high bias and variance. We propose a principled framework for deriving task-specific strictly proper scoring rules by matching the local curvature of the downstream error metric. We apply this to the Average Treatment Effect (ATE) estimation, deriving a closed-form loss and its corresponding canonical probability mapping that can be readily integrated with any model like a neural network or a gradient boosting algorithm. Extensive evaluations on causal inference benchmarks demonstrate that our tailored objective consistently outperforms standard likelihood-based and covariate-balancing approaches.
Roman Plaud, Alexandre Perez-Lebel, Antoine Saillenfest +4