Causal Counterfactual visualisation for human causal decision making - A case study in healthcare

因果关系的概念是我们理解世界的核心，也是人类决策的关键。因果关系从根本上不同于关联，因为它表现出干预的后果。有证据表明，不同的因果信念往往会导致不同的健康结果。目前，心理学研究仍然没有提供关于人们如何在现实世界的决策中做出因果判断的许多基本问题的答案。根据最近的因果心理学理论，人们的因果判断是基于评估一个假定的原因是否（以及如何）对结果产生影响。至关重要的是，这些判断依赖于反事实对比，即如果假定的原因没有发生，会发生什么？这包括在心理模拟中设想现实世界的其他可能性。为此，可视化在支持人们的反事实思维方面具有很大的潜力，尤其是在面对复杂的场景时。然而，到目前为止，在帮助因果决策的背景下解决反事实可视化的工作很少。本研究将调查新的因果反事实可视化，与真实数据的直接可视化相比，它将具有呈现现实中未发生的因果反事实的新功能。反事实将由一个用真实数据训练的反事实模拟模型生成。这扩展了标准的数据可视化，通过可视化超出真实数据的假设示例。它将支持“用实例解释”，使决策者能够交互式地创建合成数据，并检查“接近可能的世界”（例如，一个小的因果变化产生的不同结果）。可视化的具体例子将允许人们查看关键证据，并对他们的决定与反事实进行辩论，以获得可操作的见解。因果反事实可视化将得到该团队成员在心理学和人工智能领域取得的最新进展的支持。通过汇集多学科团队的专业知识，新的因果反事实可视化技术将提供一个有用的渠道，以评估和进一步我们对人类行为和表现的理解，并借助视觉呈现，特别是关于可视化的作用。我们将在临床案例研究的背景下进行一系列心理学实验，以探讨医疗保健中的因果决策，这将涉及医生的参与和共同设计。在涉及两个临床案例的心理实验中，医生将使用可视化工具来制定和检验因果假设，以便决策：(1)基于肺癌发生的因果危险因素的临床判断，针对个体患者的单位层面因果关系；(2)通过测量药物对糖尿病治疗的因果效应进行临床试验，针对人群水平的因果关系。通过定制的模拟，可视化将揭示替代治疗的潜在结果及其疗效和副作用的权衡，以便通过可视化具体的反事实（例如医学测试、筛查、图像）进行比较。此外，研究人员可以在模拟临床试验中评估治疗组和对照组之间的差异，并查看违反他们假设的例子。通过这两个临床用例，研究成果将在医疗保健环境中直接衡量，在医疗保健环境中，临床医生面临着复杂的医学环境，大量的输入和来自多个来源的数据的相互作用，以做出重要的临床决策。这项工作将展示新的可视化如何寻求解决这一问题，从而减少可变性，并通过临床医生可以解释的可操作见解支持稳健的决策制定。

The concept of causation is central to our understanding of the world and key to human decision making. Causation is fundamentally different from association as it exhibits consequences of interventions. Evidence shows that different causal beliefs tend to result in different health outcomes. At present, psychology research still does not provide answers to many fundamental questions about how people make causal judgements in real-world decisions. According to recent psychological theories of causation, people's causal judgments are based on assessing whether (and how) an presumed cause makes a difference to an outcome. Crucially, these judgements hinge on counterfactual contrasts, namely what would have happened if the presumed cause had not occurred? This involves envisaging alternative possibilities to the actual world in mental simulations. To this end, visualisation has great potential to support people's counterfactual thinking, especially in the face of complex scenarios. However, so far very little work has addressed counterfactual visualisation in the context of aiding causal decision making.This research will investigate novel causal counterfactual visualisation, which will, in contrast to the direct visualisation of real data, have a new functionality to render causal counterfactuals that did not occur in reality. The counterfactuals will be generated by a counterfactual simulation model that is trained with real data. This extends standard data visualisation by visualising hypothetical exemplars beyond real data. It will support "explanation-with-examples" by enabling decision makers to interactively create synthetic data and examine "close possible worlds" (e.g. different outcomes from a small causal change). Visualising concrete exemplars will allow people to view key evidence and contest their decisions against the counterfactuals to gain actionable insights.Causal counterfactual visualisation will be underpinned by the latest advance in both psychology and AI domains made by the members of this team. By bringing together expertise from a multidisciplinary team, the new causal counterfactual visualisation techniques will offer an useful channel to assess and further our understanding of human behaviour and performance in causal decision making with the aid of visual presentation, especially with respect to the role of visualisation.We will conduct a series of psychological experiments in the context of clinical case studies to probe causal decision making in healthcare, which will involve participations and co-design with doctors. Doctors will use the visualisation tool to make and test causal hypotheses for decision making in the psychological experiments involving two clinical cases: (1) Clinical judgement based on causal risk factors of developing lung cancer, which targets unit-level causality about individual patients; (2) Clinical trial of a drug by measuring its causal effect on diabetes treatment, which targets causation at the population-level. With customised simulations, the visualisation will reveal potential outcomes of alternative treatments and their trade-off in efficacy & side-effects to enable comparisons by visualising concrete counterfactuals (e.g. medical tests, screening, images). Also, researchers can assess difference between treatment and control groups in a simulated clinical trial, and view examples that violate their hypotheses. Through the two clinical use cases, the research outcomes will be directly measured in the healthcare setting, where clinicians face complex landscape of medicine with overwhelming number of input and interplay of data from multiple sources to make important clinical decisions. This work is about to demonstrate how the new visualisation can seek to resolve this leading to reduction variability and support robust decision making with actionable insights that clinicians can interpret.