Counterfactual Prediction Under Outcome Measurement Error

TL;DR

This paper introduces methods to improve predictive models affected by outcome measurement error, treatment effects, and selection bias, especially when proxies are used for true outcomes, demonstrated through healthcare and employment data.

Contribution

It develops an unbiased risk minimization approach that corrects for combined measurement error, treatment effects, and bias, and estimates unknown measurement error parameters.

Findings

The proposed method improves model reliability under measurement error conditions.

Models correcting for measurement error or treatment effects alone are less reliable.

The approach is validated on real-world healthcare and employment data.

Abstract

Across domains such as medicine, employment, and criminal justice, predictive models often target labels that imperfectly reflect the outcomes of interest to experts and policymakers. For example, clinical risk assessments deployed to inform physician decision-making often predict measures of healthcare utilization (e.g., costs, hospitalization) as a proxy for patient medical need. These proxies can be subject to outcome measurement error when they systematically differ from the target outcome they are intended to measure. However, prior modeling efforts to characterize and mitigate outcome measurement error overlook the fact that the decision being informed by a model often serves as a risk-mitigating intervention that impacts the target outcome of interest and its recorded proxy. Thus, in these settings, addressing measurement error requires counterfactual modeling of treatment effects on outcomes. In this work, we study intersectional threats to model reliability introduced by outcome measurement error, treatment effects, and selection bias from historical decision-making policies. We develop an unbiased risk minimization method which, given knowledge of proxy measurement error properties, corrects for the combined effects of these challenges. We also develop a method for estimating treatment-dependent measurement error parameters when these are unknown in advance. We demonstrate the utility of our approach theoretically and via experiments on real-world data from randomized controlled trials conducted in healthcare and employment domains. As importantly, we demonstrate that models correcting for outcome measurement error or treatment effects alone suffer from considerable reliability limitations. Our work underscores the importance of considering intersectional threats to model validity during the design and evaluation of predictive models for decision support.