{"id":"https://openalex.org/W7164420280","doi":"https://doi.org/10.1016/j.compbiomed.2026.111807","title":"Causal counterfactual simulation for treatment decisions in multimodal lung disease data","display_name":"Causal counterfactual simulation for treatment decisions in multimodal lung disease data","publication_year":2026,"publication_date":"2026-06-11","ids":{"openalex":"https://openalex.org/W7164420280","doi":"https://doi.org/10.1016/j.compbiomed.2026.111807","pmid":"https://pubmed.ncbi.nlm.nih.gov/42275812"},"language":"en","primary_location":{"id":"doi:10.1016/j.compbiomed.2026.111807","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.compbiomed.2026.111807","pdf_url":null,"source":{"id":"https://openalex.org/S44278595","display_name":"Computers in Biology and Medicine","issn_l":"0010-4825","issn":["0010-4825","1879-0534"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Computers in Biology and Medicine","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://doi.org/10.1016/j.compbiomed.2026.111807","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5138464938","display_name":"Yifei Zhu","orcid":"https://orcid.org/0009-0009-8261-2759"},"institutions":[{"id":"https://openalex.org/I23923803","display_name":"University of Exeter","ror":"https://ror.org/03yghzc09","country_code":"GB","type":"education","lineage":["https://openalex.org/I23923803"]}],"countries":["GB"],"is_corresponding":true,"raw_author_name":"Yifei Zhu","raw_affiliation_strings":["Department of Computer Science, University of Exeter, Exeter, UK. Electronic address: y.zhu4@exeter.ac.uk"],"raw_orcid":"https://orcid.org/0009-0009-8261-2759","affiliations":[{"raw_affiliation_string":"Department of Computer Science, University of Exeter, Exeter, UK. Electronic address: y.zhu4@exeter.ac.uk","institution_ids":["https://openalex.org/I23923803"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5133108197","display_name":"Lei Zhang","orcid":null},"institutions":[{"id":"https://openalex.org/I23923803","display_name":"University of Exeter","ror":"https://ror.org/03yghzc09","country_code":"GB","type":"education","lineage":["https://openalex.org/I23923803"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Lei Zhang","raw_affiliation_strings":["Department of Computer Science, University of Exeter, Exeter, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Computer Science, University of Exeter, Exeter, UK","institution_ids":["https://openalex.org/I23923803"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5112250373","display_name":"Chris Sainsbury","orcid":null},"institutions":[{"id":"https://openalex.org/I2800201399","display_name":"NHS Greater Glasgow and Clyde","ror":"https://ror.org/05kdz4d87","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2800201399"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Chris Sainsbury","raw_affiliation_strings":["Institute of Applied Health Research, University of Birmingham, Birmingham, UK; NHS Greater Glasgow and Clyde, Glasgow, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Institute of Applied Health Research, University of Birmingham, Birmingham, UK; NHS Greater Glasgow and Clyde, Glasgow, UK","institution_ids":["https://openalex.org/I2800201399"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5138464773","display_name":"Feng Dong","orcid":null},"institutions":[{"id":"https://openalex.org/I181647926","display_name":"University of Strathclyde","ror":"https://ror.org/00n3w3b69","country_code":"GB","type":"education","lineage":["https://openalex.org/I181647926"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Feng Dong","raw_affiliation_strings":["Department of Computer and Information Sciences, University of Strathclyde, Glasgow, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Computer and Information Sciences, University of Strathclyde, Glasgow, UK","institution_ids":["https://openalex.org/I181647926"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5030427594","display_name":"John D. Maclay","orcid":"https://orcid.org/0000-0002-2531-7712"},"institutions":[{"id":"https://openalex.org/I2800201399","display_name":"NHS Greater Glasgow and Clyde","ror":"https://ror.org/05kdz4d87","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2800201399"]},{"id":"https://openalex.org/I2800666604","display_name":"Glasgow Royal Infirmary","ror":"https://ror.org/00bjck208","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2800201399","https://openalex.org/I2800666604"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"John MacLay","raw_affiliation_strings":["NHS Greater Glasgow and Clyde, Glasgow, UK; Respiratory Department, Glasgow Royal Infirmary, Glasgow, UK"],"raw_orcid":"https://orcid.org/0000-0002-2531-7712","affiliations":[{"raw_affiliation_string":"NHS Greater Glasgow and Clyde, Glasgow, UK; Respiratory Department, Glasgow Royal Infirmary, Glasgow, UK","institution_ids":["https://openalex.org/I2800201399","https://openalex.org/I2800666604"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5102965369","display_name":"David J. Lowe","orcid":"https://orcid.org/0000-0003-4866-2049"},"institutions":[{"id":"https://openalex.org/I4210158502","display_name":"Queen Elizabeth University Hospital","ror":"https://ror.org/04y0x0x35","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2800201399","https://openalex.org/I4210158502"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"David J. Lowe","raw_affiliation_strings":["Digital Health Validation Lab, University of Glasgow, Glasgow, UK; Emergency Department, Queen Elizabeth University Hospital, Glasgow, UK"],"raw_orcid":"https://orcid.org/0000-0003-4866-2049","affiliations":[{"raw_affiliation_string":"Digital Health Validation Lab, University of Glasgow, Glasgow, UK; Emergency Department, Queen Elizabeth University Hospital, Glasgow, UK","institution_ids":["https://openalex.org/I4210158502"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5037392936","display_name":"Xujiong Ye","orcid":"https://orcid.org/0000-0003-0115-0724"},"institutions":[{"id":"https://openalex.org/I23923803","display_name":"University of Exeter","ror":"https://ror.org/03yghzc09","country_code":"GB","type":"education","lineage":["https://openalex.org/I23923803"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Xujiong Ye","raw_affiliation_strings":["Department of Computer Science, University of Exeter, Exeter, UK"],"raw_orcid":"https://orcid.org/0000-0003-0115-0724","affiliations":[{"raw_affiliation_string":"Department of Computer Science, University of Exeter, Exeter, UK","institution_ids":["https://openalex.org/I23923803"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":5,"corresponding_author_ids":["https://openalex.org/A5138464938"],"corresponding_institution_ids":["https://openalex.org/I23923803"],"apc_list":{"value":2610,"currency":"USD","value_usd":2610},"apc_paid":{"value":2610,"currency":"USD","value_usd":2610},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.7511058,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"213","issue":null,"first_page":"111807","last_page":"111807"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10775","display_name":"Generative Adversarial Networks and Image Synthesis","score":0.322299987077713,"subfield":{"id":"https://openalex.org/subfields/1707","display_name":"Computer Vision and Pattern Recognition"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T10775","display_name":"Generative Adversarial Networks and Image Synthesis","score":0.322299987077713,"subfield":{"id":"https://openalex.org/subfields/1707","display_name":"Computer Vision and Pattern Recognition"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.16349999606609344,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T12422","display_name":"Radiomics and Machine Learning in Medical Imaging","score":0.09070000052452087,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/counterfactual-thinking","display_name":"Counterfactual thinking","score":0.8736000061035156},{"id":"https://openalex.org/keywords/observational-study","display_name":"Observational study","score":0.6669999957084656},{"id":"https://openalex.org/keywords/psychological-intervention","display_name":"Psychological intervention","score":0.5130000114440918},{"id":"https://openalex.org/keywords/causal-inference","display_name":"Causal inference","score":0.49810001254081726},{"id":"https://openalex.org/keywords/clinical-trial","display_name":"Clinical trial","score":0.45750001072883606},{"id":"https://openalex.org/keywords/disease","display_name":"Disease","score":0.4187999963760376},{"id":"https://openalex.org/keywords/confounding","display_name":"Confounding","score":0.4163999855518341}],"concepts":[{"id":"https://openalex.org/C108650721","wikidata":"https://www.wikidata.org/wiki/Q1783253","display_name":"Counterfactual thinking","level":2,"score":0.8736000061035156},{"id":"https://openalex.org/C23131810","wikidata":"https://www.wikidata.org/wiki/Q818574","display_name":"Observational study","level":2,"score":0.6669999957084656},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.5232999920845032},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.5130000114440918},{"id":"https://openalex.org/C158600405","wikidata":"https://www.wikidata.org/wiki/Q5054566","display_name":"Causal inference","level":2,"score":0.49810001254081726},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.476500004529953},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.4706000089645386},{"id":"https://openalex.org/C119857082","wikidata":"https://www.wikidata.org/wiki/Q2539","display_name":"Machine learning","level":1,"score":0.45899999141693115},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.45750001072883606},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.4187999963760376},{"id":"https://openalex.org/C77350462","wikidata":"https://www.wikidata.org/wiki/Q1125472","display_name":"Confounding","level":2,"score":0.4163999855518341},{"id":"https://openalex.org/C2780801425","wikidata":"https://www.wikidata.org/wiki/Q5164392","display_name":"Construct (python library)","level":2,"score":0.4032999873161316},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.3944999873638153},{"id":"https://openalex.org/C2776401178","wikidata":"https://www.wikidata.org/wiki/Q12050496","display_name":"Feature (linguistics)","level":2,"score":0.34940001368522644},{"id":"https://openalex.org/C11671645","wikidata":"https://www.wikidata.org/wiki/Q5054567","display_name":"Causal model","level":2,"score":0.3167000114917755},{"id":"https://openalex.org/C153701036","wikidata":"https://www.wikidata.org/wiki/Q659974","display_name":"Trustworthiness","level":2,"score":0.31139999628067017},{"id":"https://openalex.org/C99508421","wikidata":"https://www.wikidata.org/wiki/Q2678675","display_name":"Physical medicine and rehabilitation","level":1,"score":0.29600000381469727},{"id":"https://openalex.org/C205606062","wikidata":"https://www.wikidata.org/wiki/Q5249645","display_name":"Decoupling (probability)","level":2,"score":0.29280000925064087},{"id":"https://openalex.org/C19527891","wikidata":"https://www.wikidata.org/wiki/Q1120908","display_name":"Medical physics","level":1,"score":0.2648000121116638},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.25609999895095825}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.1016/j.compbiomed.2026.111807","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.compbiomed.2026.111807","pdf_url":null,"source":{"id":"https://openalex.org/S44278595","display_name":"Computers in Biology and Medicine","issn_l":"0010-4825","issn":["0010-4825","1879-0534"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Computers in Biology and Medicine","raw_type":"journal-article"},{"id":"pmid:42275812","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42275812","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Computers in biology and medicine","raw_type":null},{"id":"pmh:oai:eprints.gla.ac.uk:389258","is_oa":true,"landing_page_url":"https://eprints.gla.ac.uk/view/author/29794.html>","pdf_url":null,"source":{"id":"https://openalex.org/S4210235606","display_name":"ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam)","issn_l":"2622-8912","issn":["2622-8912","2622-8920"],"is_oa":true,"is_in_doaj":true,"is_core":false,"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":null,"raw_type":"Articles"},{"id":"pmh:oai:strathprints.strath.ac.uk:96650","is_oa":false,"landing_page_url":"https://strathprints.strath.ac.uk/view/author/1257690.html>","pdf_url":null,"source":{"id":"https://openalex.org/S4306402226","display_name":"Strathprints: The University of Strathclyde institutional repository (University of Strathclyde)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I181647926","host_organization_name":"University of Strathclyde","host_organization_lineage":["https://openalex.org/I181647926"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":null,"raw_type":"Article"}],"best_oa_location":{"id":"doi:10.1016/j.compbiomed.2026.111807","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.compbiomed.2026.111807","pdf_url":null,"source":{"id":"https://openalex.org/S44278595","display_name":"Computers in Biology and Medicine","issn_l":"0010-4825","issn":["0010-4825","1879-0534"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Computers in Biology and Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.5049740672111511,"display_name":"Good health and well-being"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320334627","display_name":"Engineering and Physical Sciences Research Council","ror":"https://ror.org/0439y7842"}],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":19,"referenced_works":["https://openalex.org/W1993244478","https://openalex.org/W1993482188","https://openalex.org/W2106171250","https://openalex.org/W2186478222","https://openalex.org/W2768146862","https://openalex.org/W2890139949","https://openalex.org/W2905472553","https://openalex.org/W2981869278","https://openalex.org/W2995225687","https://openalex.org/W2995750307","https://openalex.org/W3009072071","https://openalex.org/W3016970897","https://openalex.org/W3080627676","https://openalex.org/W4319067116","https://openalex.org/W4376132900","https://openalex.org/W4388492864","https://openalex.org/W4404696667","https://openalex.org/W4416122907","https://openalex.org/W7083685453"],"related_works":[],"abstract_inverted_index":{"While":[0],"deep":[1],"learning":[2],"has":[3],"advanced":[4],"the":[5,24,57,124,200],"automated":[6],"diagnosis":[7],"of":[8,114],"pulmonary":[9,176],"diseases":[10],"from":[11,190],"chest":[12,141],"X-rays,":[13],"transitioning":[14],"these":[15],"models":[16,64],"to":[17,56,101,122,143,150,175,182,217],"treatment":[18,87,105,188,201,208,223],"optimisation":[19],"is":[20],"fundamentally":[21],"hindered":[22],"by":[23,90,155],"reliance":[25],"on":[26,129],"biased":[27],"observational":[28],"data.":[29],"In":[30],"datasets,":[31],"such":[32],"as":[33,112],"MIMIC,":[34],"confounding":[35],"factors":[36],"create":[37],"a":[38,79,97,118,213],"\"Treatment":[39],"Paradox\",":[40],"where":[41],"active":[42],"interventions":[43],"are":[44,53],"statistically":[45],"correlated":[46],"with":[47,212],"higher":[48],"mortality":[49],"simply":[50],"because":[51],"they":[52],"preferentially":[54],"assigned":[55],"most":[58],"severely":[59],"ill":[60],"patients.":[61],"Consequently,":[62],"standard":[63],"learn":[65],"clinical":[66,93,98],"assignment":[67],"patterns":[68],"rather":[69],"than":[70],"true":[71,187],"physiological":[72,104],"efficacy.":[73],"To":[74],"address":[75],"this,":[76],"we":[77,95,116,162],"propose":[78],"causal":[80],"synthesis":[81],"strategy":[82],"that":[83],"generates":[84,206],"de-confounded,":[85],"high-dimensional":[86],"counterfactuals.":[88],"Guided":[89],"our":[91,196],"experts'":[92],"priors,":[94],"construct":[96],"transition":[99],"matrix":[100],"simulate":[102],"genuine":[103],"effects.":[106],"Using":[107],"patient":[108,157],"white":[109],"blood":[110],"cells":[111],"measure":[113],"severity,":[115],"applied":[117],"disease":[119,145],"counterfactual":[120,173],"model":[121],"generate":[123],"corresponding":[125],"post-treatment":[126,140],"images":[127],"based":[128],"this":[130,204],"matrix.":[131],"Our":[132],"longitudinal":[133],"generative":[134],"architecture":[135],"uses":[136],"both":[137],"pre-":[138],"and":[139,193,225],"X-rays":[142],"capture":[144],"evolution":[146],"over":[147],"time.":[148],"Furthermore,":[149],"resolve":[151],"spatial":[152],"misalignments":[153],"caused":[154],"varying":[156],"postures":[158],"across":[159],"temporal":[160],"scans,":[161],"introduce":[163],"an":[164],"explicit":[165],"lung":[166],"mask":[167],"constraint.":[168],"This":[169],"anatomy-aware":[170],"mechanism":[171],"confines":[172],"modifications":[174],"regions,":[177],"preventing":[178],"clinically":[179],"implausible":[180],"alterations":[181],"background":[183],"anatomy.":[184],"By":[185],"decoupling":[186],"effects":[189],"baseline":[191],"severity":[192],"posture":[194],"variations,":[195],"framework":[197],"successfully":[198],"resolves":[199],"paradox.":[202],"Ultimately,":[203],"approach":[205],"realistic":[207],"counterfactuals,":[209],"providing":[210],"clinicians":[211],"trustworthy":[214],"visual":[215],"tool":[216],"evaluate":[218],"patient-specific":[219],"outcomes":[220],"under":[221],"alternative":[222],"scenarios":[224],"support":[226],"medical":[227],"decision-making.":[228]},"counts_by_year":[],"updated_date":"2026-07-18T07:39:51.176621","created_date":"2026-06-12T00:00:00"}