论文标题
TOPCAT试验的因果分析：螺内酯保留的心脏功能心力衰竭
Causal Analysis of the TOPCAT Trial: Spironolactone for Preserved Cardiac Function Heart Failure
论文作者
论文摘要
我们描述了将因果发现方法应用于多站点临床试验的数据的结果，这些试验与醛固酮拮抗剂（TOPCAT）处理保留的心脏功能心力衰竭。该试验尚无定论，整个队列没有始终显示出明显的好处。但是，关于同类地理亚组的诊断和治疗方案的可靠性存在疑问。通过以域知识形式包含医学环境，因果发现用于证明区域差异并构建结果的区域运输能力。此外，我们表明，在全球范围内，尤其是对于某些亚组，该治疗具有显着的因果作用，因此对试验结果提供了更精致的视野。
We describe the results of applying causal discovery methods on the data from a multi-site clinical trial, on the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT). The trial was inconclusive, with no clear benefits consistently shown for the whole cohort. However, there were questions regarding the reliability of the diagnosis and treatment protocol for a geographic subgroup of the cohort. With the inclusion of medical context in the form of domain knowledge, causal discovery is used to demonstrate regional discrepancies and to frame the regional transportability of the results. Furthermore, we show that, globally and especially for some subgroups, the treatment has significant causal effects, thus offering a more refined view of the trial results.
