Optimal two-stage dynamic treatment regimes from a classification perspective with censored survival data

Biometrics
Rebecca HagerMarie Davidian

Abstract

Clinicians often make multiple treatment decisions at key points over the course of a patient's disease. A dynamic treatment regime is a sequence of decision rules, each mapping a patient's observed history to the set of available, feasible treatment options at each decision point, and thus formalizes this process. An optimal regime is one leading to the most beneficial outcome on average if used to select treatment for the patient population. We propose a method for estimation of an optimal regime involving two decision points when the outcome of interest is a censored survival time, which is based on maximizing a locally efficient, doubly robust, augmented inverse probability weighted estimator for average outcome over a class of regimes. By casting this optimization as a classification problem, we exploit well-studied classification techniques such as support vector machines to characterize the class of regimes and facilitate implementation via a backward iterative algorithm. Simulation studies of performance and application of the method to data from a sequential, multiple assignment randomized clinical trial in acute leukemia are presented.

References

Nov 12, 2005·Clinical Trials : Journal of the Society for Clinical Trials·Philip W Lavori, Ree Dawson
May 4, 2012·Biometrics·Baqun ZhangMarie Davidian
Jul 4, 2012·Annals of Statistics·Yair Goldberg, Michael R Kosorok
May 1, 2013·Journal of the American Statistical Association·Yingqi ZhaoMichael R Kosorok
Jan 27, 2015·Statistical Science : a Review Journal of the Institute of Mathematical Statistics·Phillip J SchulteMarie Davidian
Aug 4, 2015·Journal of the American Statistical Association·Ying-Qi ZhaoMichael R Kosorok
Dec 27, 2016·Journal of the American Statistical Association·Yanxun XuPeter F Thall
Oct 7, 2017·Journal of the Royal Statistical Society. Series B, Statistical Methodology·Runchao JiangMarie Davidian

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Citations

Jan 18, 2020·Statistics in Medicine·Ying-Qi ZhaoYingye Zheng
Apr 15, 2020·Bone Marrow Transplantation·Erica E M Moodie, Elizabeth F Krakow
Sep 16, 2020·Statistics in Medicine·Gabrielle SimoneauRobert W Platt
Sep 23, 2021·Statistics in Medicine·Yuexin FangMin Zhang

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