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Main Authors: Zhang, Peisong, Peng, Manqiang, Wu, Yuxuan, Phadungsaksawasdi, Pawit, Yeung, Wesley, Zhang, Ye, Nguyen, Trang, Zhang, Qiang, Liu, Nan, Wang, Meng, Ngiam, Kee Yuan, Tham, Yih-Chung, Cheng, Ching-Yu, Fu, Tianfan, Chen, Qingyu, Ke, Rosemary, Li, Chang, Yang, Wenzhuo, Lu, Zhenghao, Lai, Chunyou, Zhang, Yu, Zhong, Sheng, Deng, Hao, Liu, Dianbo
Format: Preprint
Published: 2026
Subjects:
Online Access:https://arxiv.org/abs/2605.05706
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author Zhang, Peisong
Peng, Manqiang
Wu, Yuxuan
Phadungsaksawasdi, Pawit
Yeung, Wesley
Zhang, Ye
Nguyen, Trang
Zhang, Qiang
Liu, Nan
Wang, Meng
Ngiam, Kee Yuan
Tham, Yih-Chung
Cheng, Ching-Yu
Fu, Tianfan
Chen, Qingyu
Ke, Rosemary
Li, Chang
Yang, Wenzhuo
Lu, Zhenghao
Lai, Chunyou
Zhang, Yu
Zhong, Sheng
Deng, Hao
Liu, Dianbo
author_facet Zhang, Peisong
Peng, Manqiang
Wu, Yuxuan
Phadungsaksawasdi, Pawit
Yeung, Wesley
Zhang, Ye
Nguyen, Trang
Zhang, Qiang
Liu, Nan
Wang, Meng
Ngiam, Kee Yuan
Tham, Yih-Chung
Cheng, Ching-Yu
Fu, Tianfan
Chen, Qingyu
Ke, Rosemary
Li, Chang
Yang, Wenzhuo
Lu, Zhenghao
Lai, Chunyou
Zhang, Yu
Zhong, Sheng
Deng, Hao
Liu, Dianbo
contents Estimating individualized treatment effects from longitudinal observational data is central to data-driven medicine, yet existing methods face a fundamental limitation: reducing confounding bias often suppresses clinically informative heterogeneity, degrading patient-specific predictions. Here, we identify this tension as a bias-precision paradox in causal representation learning and introduce sampling-based maximum mean discrepancy (sMMD), a stochastic alignment strategy that replaces global adversarial balancing with subset-level matching. We instantiate this approach in a framework for counterfactual outcome prediction with attribution-grounded interpretability. Across two large-scale ICU cohorts (n = 27,783), our framework improves accuracy under distribution shift, reducing error by up to 11.5% and substantially increasing recall in high-risk tasks. Mechanistic analyses show that sMMD selectively preserves clinically decisive variables. In human-AI evaluation, our method outperforms clinicians-in-training and large language models, and improves clinician accuracy by 14.7% while reducing decision time, enabling interpretable, real-time clinical decision support.
format Preprint
id arxiv_https___arxiv_org_abs_2605_05706
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Resolving the bias-precision paradox with stochastic causal representation learning for personalized medicine
Zhang, Peisong
Peng, Manqiang
Wu, Yuxuan
Phadungsaksawasdi, Pawit
Yeung, Wesley
Zhang, Ye
Nguyen, Trang
Zhang, Qiang
Liu, Nan
Wang, Meng
Ngiam, Kee Yuan
Tham, Yih-Chung
Cheng, Ching-Yu
Fu, Tianfan
Chen, Qingyu
Ke, Rosemary
Li, Chang
Yang, Wenzhuo
Lu, Zhenghao
Lai, Chunyou
Zhang, Yu
Zhong, Sheng
Deng, Hao
Liu, Dianbo
Artificial Intelligence
Quantitative Methods
Estimating individualized treatment effects from longitudinal observational data is central to data-driven medicine, yet existing methods face a fundamental limitation: reducing confounding bias often suppresses clinically informative heterogeneity, degrading patient-specific predictions. Here, we identify this tension as a bias-precision paradox in causal representation learning and introduce sampling-based maximum mean discrepancy (sMMD), a stochastic alignment strategy that replaces global adversarial balancing with subset-level matching. We instantiate this approach in a framework for counterfactual outcome prediction with attribution-grounded interpretability. Across two large-scale ICU cohorts (n = 27,783), our framework improves accuracy under distribution shift, reducing error by up to 11.5% and substantially increasing recall in high-risk tasks. Mechanistic analyses show that sMMD selectively preserves clinically decisive variables. In human-AI evaluation, our method outperforms clinicians-in-training and large language models, and improves clinician accuracy by 14.7% while reducing decision time, enabling interpretable, real-time clinical decision support.
title Resolving the bias-precision paradox with stochastic causal representation learning for personalized medicine
topic Artificial Intelligence
Quantitative Methods
url https://arxiv.org/abs/2605.05706