Distributional Treatment Effect Estimation across Heterogeneous Sites via Optimal Transport

We propose a novel framework for synthesizing counterfactual treatment group data in a target site by integrating full treatment and control group data from a source site with control group data from the target. Departing from conventional average treatment effect estimation, our approach adopts a distributional causal inference perspective by modeling treatment and control as distinct probability measures on the source and target sites. We formalize the cross-site heterogeneity (effect modification) as a push-forward transformation that maps the joint feature-outcome distribution from the source to the target site. This transformation is learned by aligning the control group distributions between sites using an Optimal Transport-based procedure, and subsequently applied to the source treatment group to generate the synthetic target treatment distribution. Under general regularity conditions, we establish theoretical guarantees for the consistency and asymptotic convergence of the synthetic treatment group data to the true target distribution. Simulation studies across multiple data-generating scenarios and a real-world application to patient-derived xenograft data demonstrate that our framework robustly recovers the full distributional properties of treatment effects.