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Precise estimation of treatment effects is crucial for accurately evaluating the intervention. While deep learning models have exhibited promising performance in learning counterfactual representations for treatment effect estimation (TEE), a major limitation in most of these models is that they often overlook the diversity of treatment effects across potential subgroups that have varying treatment effects and characteristics, treating the entire population as a homogeneous group. This limitation restricts the ability to precisely estimate treatment effects and provide targeted treatment recommendations. In this paper, we propose a novel treatment effect estimation model, named SubgroupTE, which incorporates subgroup identification in TEE. SubgroupTE identifies heterogeneous subgroups with different responses and more precisely estimates treatment effects by considering subgroup-specific treatment effects in the estimation process. In addition, we introduce an expectation–maximization (EM)-based training process that iteratively optimizes estimation and subgrouping networks to improve both estimation and subgroup identification. Comprehensive experiments on the synthetic and semi-synthetic datasets demonstrate the outstanding performance of SubgroupTE compared to the existing works for treatment effect estimation and subgrouping models. Additionally, a real-world study demonstrates the capabilities of SubgroupTE in enhancing targeted treatment recommendations for patients with opioid use disorder (OUD) by incorporating subgroup identification with treatment effect estimation. 

Despite intense efforts in basic and clinical research, an individualized ventilation strategy for critically ill patients remains a major challenge. Recently, dynamic treatment regime (DTR) with reinforcement learning (RL) on electronic health records (EHR) has attracted interest from both the healthcare industry and machine learning research community. However, most learned DTR policies might be biased due to the existence of confounders. Although some treatment actions non-survivors received may be helpful, if confounders cause the mortality, the training of RL models guided by long-term outcomes (e.g., 90-day mortality) would punish those treatment actions causing the learned DTR policies to be suboptimal. In this study, we develop a new deconfounding actor-critic network (DAC) to learn optimal DTR policies for patients. To alleviate confounding issues, we incorporate a patient resampling module and a confounding balance module into our actor-critic framework. To avoid punishing the effective treatment actions non-survivors received, we design a short-term reward to capture patients' immediate health state changes. Combining short-term with long-term rewards could further improve the model performance. Moreover, we introduce a policy adaptation method to successfully transfer the learned model to new-source small-scale datasets. The experimental results on one semi-synthetic and two different real-world datasets show the proposed model outperforms the state-of-the-art models. The proposed model provides individualized treatment decisions for mechanical ventilation that could improve patient outcomes.