Semi-Parametric Identification and Estimation of Interaction and Effect Modification in Mixed Exposures using Stochastic Interventions

In many fields, including environmental epidemiology, researchers strive to understand the joint impact of a mixture of exposures. This involves analyzing a vector of exposures rather than a single exposure, with the most significant exposure sets being unknown. Examining every possible interaction or effect modification in a high-dimensional vector of candidates can be challenging or even impossible. To address this challenge, we propose a method for the automatic identification and estimation of exposure sets in a mixture with explanatory power, baseline covariates that modify the impact of an exposure and sets of exposures that have synergistic non-additive relationships. We define these parameters in a realistic nonparametric statistical model and use machine learning methods to identify variables sets and estimate nuisance parameters for our target parameters to avoid model misspecification. We establish a prespecified target parameter applied to variable sets when identified and use cross-validation to train efficient estimators employing targeted maximum likelihood estimation for our target parameter. Our approach applies a shift intervention targeting individual variable importance, interaction, and effect modification based on the data-adaptively determined sets of variables. Our methodology is implemented in the open-source SuperNOVA package in R. We demonstrate the utility of our method through simulations, showing that our estimator is efficient and asymptotically linear under conditions requiring fast convergence of certain regression functions. We apply our method to the National Institute of Environmental Health Science mixtures workshop data, revealing correct identification of antagonistic and agonistic interactions built into the data. Additionally, we investigate the association between exposure to persistent organic pollutants and longer leukocyte telomere length.