The discovery of a data-driven causal diagram of sport participation in children and adolescents with heart disease: a pilot study

Jakub S Gąsior; Marcel Młyńczak; Craig A Williams; Aleksandra Popłonyk; Daria Kowalska; Paulina Giezek; Bożena Werner

doi:10.3389/fcvm.2023.1247122

The discovery of a data-driven causal diagram of sport participation in children and adolescents with heart disease: a pilot study

Front Cardiovasc Med. 2023 Nov 21:10:1247122. doi: 10.3389/fcvm.2023.1247122. eCollection 2023.

Authors

Jakub S Gąsior¹, Marcel Młyńczak², Craig A Williams³, Aleksandra Popłonyk⁴, Daria Kowalska⁴, Paulina Giezek⁴, Bożena Werner¹

Affiliations

¹ Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Warsaw, Poland.
² Faculty of Mechatronics, Institute of Metrology and Biomedical Engineering, Warsaw University of Technology, Warsaw, Poland.
³ Public Health and Sports Sciences Department, Children's Health and Exercise Research Centre, Faculty of Health and Life Sciences, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom.
⁴ Department of Physiotherapy, Medical University of Warsaw, Warsaw, Poland.

Abstract

The interventions aimed at improving the levels of physical activity (PA) in children and adolescents diagnosed with heart disease did not produce the expected outcomes. Safe participation in sport activities proposed based on actual recommendations could be a solution to promote PA in this population. The aims of this study were to discover a causal diagram of sport participation in children and youth with heart disease and establish the factors that affect and are affected thereof through the use of questionnaires. Furthermore, the study aims to qualitatively assess the reliability of the constructed diagram in comparison with existing medical knowledge. The Greedy Fast Causal Inference method was employed to conduct a data-driven search of the directed acyclic graph that represents the causal relationships within the provided observational data. This causal discovery was performed using the Tetrad software. The analysis involved a cohort of 121 Caucasian patients (50 females) diagnosed with heart disease. The age range of the patients included in the study was 8-17 years. The study findings indicate that the participants engaged in sports presented significantly higher values of health-related quality of life (QoL) and motives for participating in physical and leisure activities. Age appears to be a cause of sport participation. Sport participation appears to be a cause of participation in physical education classes, which in turn appears to be a cause of higher enjoyment. Higher enjoyment appears to be a cause of other motives for participating in physical and leisure activities, as well as a higher score in terms of physical health. The causal diagram provided a graphical representation of the causal relationship between sport participation and better QoL with potential confounders for children and adolescents with heart disease that nearly coincided with the existing literature. Clinical trials should be designed to validate clinical utility of the presented causal diagram.

Keywords: adolescents; causal diagram; children; heart defects; heart disease; pediatric patients; sport.

Grants and funding

This research was partly supported by a statutory grant to the Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Poland (grant number: 10/Z/GW/N/21).