Investigating the validity of structure learning algorithms in identifying risk factors for intervention in patients with diabetes

TL;DR

This study evaluates various structure learning algorithms to identify causal risk factors for diabetes, compares their outputs with expert knowledge, and proposes a model-averaging approach to improve intervention strategies.

Contribution

It introduces a model-averaging technique to synthesize multiple algorithms' outputs into a unified causal model for diabetes risk factors.

Findings

Algorithm choice significantly affects intervention outcomes.

The combined model aligns well with expert-elicited structures.

Openly available data and models support practical decision-making.

Abstract

Diabetes, a pervasive and enduring health challenge, imposes significant global implications on health, financial healthcare systems, and societal well-being. This study undertakes a comprehensive exploration of various structural learning algorithms to discern causal pathways amongst potential risk factors influencing diabetes progression. The methodology involves the application of these algorithms to relevant diabetes data, followed by the conversion of their output graphs into Causal Bayesian Networks (CBNs), enabling predictive analysis and the evaluation of discrepancies in the effect of hypothetical interventions within our context-specific case study. This study highlights the substantial impact of algorithm selection on intervention outcomes. To consolidate insights from diverse algorithms, we employ a model-averaging technique that helps us obtain a unique causal model for diabetes derived from a varied set of structural learning algorithms. We also investigate how each of those individual graphs, as well as the average graph, compare to the structures elicited by a domain expert who categorised graph edges into high confidence, moderate, and low confidence types, leading into three individual graphs corresponding to the three levels of confidence. The resulting causal model and data are made available online, and serve as a valuable resource and a guide for informed decision-making by healthcare practitioners, offering a comprehensive understanding of the interactions between relevant risk factors and the effect of hypothetical interventions. Therefore, this research not only contributes to the academic discussion on diabetes, but also provides practical guidance for healthcare professionals in developing efficient intervention and risk management strategies.