Evidence map›Paper›PMID 31233922›Full record

ArticleBehaviour research and therapy2019

Machine learning methods for developing precision treatment rules with observational data.

Ronald C Kessler, Robert M Bossarte, Alex Luedtke, Alan M Zaslavsky, Jose R Zubizarreta

Abstract read
In one paragraph

Article in Behaviour research and therapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed.

  1. Trial
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  3. Innovations to improve outcomes and uptake of psychotherapies for mental disorders: a state-of-the-art review.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026
    Article
  4. Article
  5. Article
  6. Article
  7. A survey on causal inference for recommendation.Innovation (Cambridge (Mass.)) · 2024
    Review
  8. Review
  9. Article
  10. Article
  11. COBMC psychiatry · 2022
    Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Review
  17. Article
  18. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ronald C KesslerDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA. Electronic address: Kessler@hcp.med.harvard.edu.
Robert M BossarteWest Virginia University Injury Control Research Center, Morgantown, WV, USA; Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, USA; VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, USA.
Alex LuedtkeDepartment of Statistics, University of Washington, Seattle, WA, USA; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Alan M ZaslavskyDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Jose R ZubizarretaDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA; Department of Statistics, Faculty of Arts and Sciences, Harvard University, Cambridge, MA, USA.

Funding

West Virginia IDEA-CTRU54GM104942 · NIGMS · WEST VIRGINIA UNIVERSITY · PI JUDITH FEINBERG · 2012 to 2026
$81.0M
NIGMS NIH HHS U54 GM104942
6 · The paper itself

Abstract

Clinical trials have identified a variety of predictor variables for use in precision treatment protocols, ranging from clinical biomarkers and symptom profiles to self-report measures of various sorts. Although such variables are informative collectively, none has proven sufficiently powerful to guide optimal treatment selection individually. This has prompted growing interest in the development of composite precision treatment rules (PTRs) that are constructed by combining information across a range of predictors. But this work has been hampered by the generally small samples in randomized clinical trials and the use of suboptimal analysis methods to analyze the resulting data. In this paper, we propose to address the sample size problem by: working with large observational electronic medical record databases rather than controlled clinical trials to develop preliminary PTRs; validating these preliminary PTRs in subsequent pragmatic trials; and using ensemble machine learning methods rather than individual algorithms to carry out statistical analyses to develop the PTRs. The major challenges in this proposed approach are that treatment are not randomly assigned in observational databases and that these databases often lack measures of key prescriptive predictors and mental disorder treatment outcomes. We proposed a tiered case-cohort design approach that uses innovative methods for measuring and balancing baseline covariates and estimating PTRs to address these challenges.

Indexed as

Clinical Decision RulesMachine LearningPrecision MedicineSuicide PreventionDatabases, FactualDecision Support Systems, ClinicalHumansInformation Storage and RetrievalObservational Studies as TopicSuicide, AttemptedClinical decision supportEnsemble machine learningPersonalized treatmentPrecision treatmentSuper learner

Identifiers

PMID31233922
PMCPMC7556331

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.