Life sciences · Preprint
arXiv · September 15, 2026
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In various fields, such as medicine and marketing, accurately predicting individual treatment effects holds significant promise. However, achieving reliable predictions alone is often insufficient for making informed decisions; it is equally important to understand why the treatment effect is higher for some individuals than for others. To address this two-fold challenge of prediction and interpretation, we introduce an algorithm based on decision trees and random forests for estimating individual treatment effects. Our algorithm is simple: it operates exactly like a standard random forest, but with a different splitting criterion, and requires no additional workarounds such as double machine learning or orthogonalization as used in Generalized random forests. It handles observational studies with varying treatment propensities without requiring separate estimation of the full propensity function. This is achieved by combining two splitting criteria---one targeting heterogeneity in the treatment effect, the other targeting bias correction for the average treatment effect---which together improve split point selection and automatically distinguish confounders from features responsible for heterogeneity. As a result, interpretation follows directly from the fitted tree structure itself, that is, from which features the trees split on and with which split statistics, without requiring separate post-hoc analysis. For the theoretical analysis of this algorithm, we consider a change point model with step functions for potential outcomes and treatment propensity and provide insights into the theoretical underpinnings of our approach. Simulation studies show that our simple algorithm achieves comparable, and often better, prediction accuracy than existing methods, while substantially improving interpretability.