Treatment effect estimation (TEE) refers to the estimation of causal effects, and it aims to compare the difference among treatment strategies on important outcomes. Current machine learning based methods are mainly trained on labeled data with specific treatments or outcomes of interest, which can be sub-optimal if the labeled data are limited. In this paper, we propose a novel transformer-based pre-training and fine-tuning framework called CURE for TEE from observational data. CURE is pre-trained on large-scale unlabeled patient data to learn representative contextual patient representations, and then fine-tuned on labeled patient data for TEE. We design a new sequence encoding for longitudinal (or structured) patient data and we incorporate structure and time into patient embeddings. Evaluated on 4 downstream TEE tasks, CURE outperforms the state-of-the-art methods in terms of an average of 3.8% and 6.9% absolute improvement in Area under the ROC Curve (AUC) and Area under the Precision-Recall Curve (AUPR), and 15.7% absolute improvement in Influence function-based Precision of Estimating Heterogeneous Effects (IF-PEHE). We further demonstrate the data scalability of CURE and verify the results with corresponding randomized clinical trials. Our proposed method provides a new machine learning paradigm for TEE based on observational data.

The authors have declared no competing interest.

This study did not receive any funding

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