Integrating probabilistic trees and causal networks for clinical and epidemiological data

Abstract

Healthcare decision-making requires not only accurate predictions but also insights into how factors influence patient outcomes. While traditional machine learning (ML) models excel at predicting outcomes, such as identifying high-risk patients, they are limited in addressing “what if” questions about interventions. This study introduces the Probabilistic Causal Fusion (PCF) framework, which integrates Causal Bayesian Networks (CBNs) and Probability Trees (PTrees) to extend beyond predictions. PCF leverages causal relationships from CBNs to structure PTrees, enabling both the quantification of factor impacts and the simulation of hypothetical interventions. The framework is evaluated on three clinically diverse, real-world datasets, MIMIC-IV, Framingham Heart Study, and BRFSS (Diabetes), demonstrating consistent predictive performance comparable to conventional ML models, while offering enhanced interpretability and causal reasoning capabilities. In contrast to conventional approaches focused solely on prediction, PCF offers a unified framework for prediction, intervention modelling, and counterfactual analysis, forming a holistic toolkit for clinical decision support. To enhance interpretability, PCF incorporates sensitivity analysis and SHapley Additive exPlanations (SHAP). Sensitivity analysis quantifies the influence of causal parameters on outcomes such as Length of Stay (LOS), Coronary Heart Disease (CHD), and Diabetes, while SHAP highlights the importance of individual features in predictive modelling. This dual-layered interpretability offers both macro-level insights into causal pathways and micro-level explanations for individual predictions. By combining causal reasoning with predictive modelling, PCF bridges the gap between clinical intuition and data-driven insights. Its ability to uncover relationships between modifiable factors and simulate hypothetical scenarios provides clinicians with a clearer understanding of causal pathways. This approach supports more informed, evidence-based decision-making, offering a robust framework for addressing complex questions in diverse healthcare settings