Evidence map›Paper›PMID 40913506›Full record

ArticleHealth services research2026

A Causal Machine Learning Framework for Estimating the Impact of Cancer Diagnosis on Receipt of Advance Care Planning.

Aaron Baird, Yichen Cheng, Jason Lesandrini, Yusen Xia

Abstract read
In one paragraph

Article in Health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Article
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

4 authors.

Aaron BairdDepartment of Computer Information Systems, College of Business, Colorado State University, Fort Collins, Colorado, USA.ORCID https://orcid.org/0000-0002-5620-2926
Yichen ChengInstitute for Insight, Robinson College of Business, Georgia State University, Atlanta, Georgia, USA.
Jason LesandriniAdvance Care Planning, Spiritual Health, and Language Access Services, Wellstar Health System, Marietta, Georgia, USA.
Yusen XiaInstitute for Insight, Robinson College of Business, Georgia State University, Atlanta, Georgia, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveDevelop a causal machine learning (causal ML) framework for estimating how a diagnosis (cancer in this study) affects the likelihood of receiving a specific health care service (advance care planning in this study) and associated heterogeneity. STUDY SETTING AND

designOur proposed framework leverages the causal forest method, combined with a population-weighted resampling and averaging over estimations strategy, to estimate average treatment effects (ATEs) and conditional average treatment effects (CATEs). Post hoc, we used best linear projections to identify covariates associated with variation in the CATEs. We illustrate the framework by applying it to a stratified random sample of patients, where the strata are defined by the crosstabulation of cancer diagnosis (diagnosed vs. not diagnosed) and ACP receipt (documented vs. not documented). DATA SOURCES AND ANALYTIC SAMPLE: We extracted deidentified patient data from October 2019 to October 2024 (n = 87,772) with explanatory variables in three categories: demographics, morbidity, and health care system utilization. PRINCIPAL

findingsIn application of the causal ML framework, we found that patients diagnosed with cancer at this health care system to be at least 17.2% more likely to have documented ACP than similar patients not diagnosed with cancer. We also found significant heterogeneity. For instance, a one standard deviation increase in in-person outpatient visits was associated with an on-average increase in the CATE estimate (by 6.1 percentage points), while a one standard deviation increase in hospital admissions, inpatient days, and surgical duration in minutes was associated with an on-average decrease in the CATE estimate (by -1.3, -5.6, and -0.5 percentage points, respectively).

conclusionsThe proposed causal ML framework enables estimation of the effect of a diagnosis on receiving a relevant health care service. In the cancer diagnosis context, it can identify patient groups less likely to receive ACP, thus informing service allocation strategies.

Indexed as

Advance Care PlanningMachine LearningNeoplasmsAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedPatient Acceptance of Health Careadvance care planningcancercausal machine learningheterogeneitypatient subgroup differences

Identifiers

PMID40913506
PMCPMC12967903

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.