Functional Causal Inference with Time-to-Event Data

Functional data analysis has proven to be a powerful tool for capturing and analyzing complex patterns and relationships in a variety of fields, allowing for more precise modeling, visualization, and decision-making. For example, in healthcare, functional data such as medical images can help doctors make more accurate diagnoses and develop more effective treatment plans. However, understanding the causal relationships between functional predictors and time-to-event outcomes remains a challenge. To address this, we propose a functional causal framework including a functional accelerated failure time (FAFT) model and three causal effect estimation approaches. The regression adjustment approach is based on conditional FAFT with subsequent confounding marginalization, while the functional-inverse-probability-weighting approach is based on marginal FAFT with well-defined functional propensity scores. The double robust approach combines the strengths of both methods and is robust to model specifications. Our method provides accurate causal effect estimations and is robust to different censoring rates. We demonstrate the performance of our framework with simulations and real-world data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) study. Our findings provide more precise subregions of the hippocampus that align with medical research, highlighting the power of this work for improving healthcare outcomes.