Evaluating Causal Discovery Algorithms for Path-Specific Fairness and Utility in Healthcare

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Main Authors: Nagesh, Nitish, Khatibi, Elahe, Hughes, Thomas, Bagheri, Mahdi, Gajane, Pratik, Rahmani, Amir M.
Format: Preprint
Published: 2026
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author Nagesh, Nitish
Khatibi, Elahe
Hughes, Thomas
Bagheri, Mahdi
Gajane, Pratik
Rahmani, Amir M.
author_facet Nagesh, Nitish
Khatibi, Elahe
Hughes, Thomas
Bagheri, Mahdi
Gajane, Pratik
Rahmani, Amir M.
contents Causal discovery in health data faces evaluation challenges when ground truth is unknown. We address this by collaborating with experts to construct proxy ground-truth graphs, establishing benchmarks for synthetic Alzheimer's disease and heart failure clinical records data. We evaluate the Peter-Clark, Greedy Equivalence Search, and Fast Causal Inference algorithms on structural recovery and path-specific fairness decomposition, going beyond composite fairness scores. On synthetic data, Peter-Clark achieved the best structural recovery. On heart failure data, Fast Causal Inference achieved the highest utility. For path-specific effects, ejection fraction contributed 3.37 percentage points to the indirect effect in the ground truth. These differences drove variations in the fairness-utility ratio across algorithms. Our results highlight the need for graph-aware fairness evaluation and fine-grained path-specific analysis when deploying causal discovery in clinical applications.
format Preprint
id arxiv_https___arxiv_org_abs_2603_15926
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Evaluating Causal Discovery Algorithms for Path-Specific Fairness and Utility in Healthcare
Nagesh, Nitish
Khatibi, Elahe
Hughes, Thomas
Bagheri, Mahdi
Gajane, Pratik
Rahmani, Amir M.
Machine Learning
Artificial Intelligence
Causal discovery in health data faces evaluation challenges when ground truth is unknown. We address this by collaborating with experts to construct proxy ground-truth graphs, establishing benchmarks for synthetic Alzheimer's disease and heart failure clinical records data. We evaluate the Peter-Clark, Greedy Equivalence Search, and Fast Causal Inference algorithms on structural recovery and path-specific fairness decomposition, going beyond composite fairness scores. On synthetic data, Peter-Clark achieved the best structural recovery. On heart failure data, Fast Causal Inference achieved the highest utility. For path-specific effects, ejection fraction contributed 3.37 percentage points to the indirect effect in the ground truth. These differences drove variations in the fairness-utility ratio across algorithms. Our results highlight the need for graph-aware fairness evaluation and fine-grained path-specific analysis when deploying causal discovery in clinical applications.
title Evaluating Causal Discovery Algorithms for Path-Specific Fairness and Utility in Healthcare
topic Machine Learning
Artificial Intelligence
url https://arxiv.org/abs/2603.15926