Identifying optimal dosage regimes under safety constraints: An application to long term opioid treatment of chronic pain.

ABSTRACT: There is growing interest and investment in precision medicine as a means to provide the best possible health care. A treatment regime formalizes precision medicine as a sequence of decision rules, one per clinical intervention period, that specify if, when and how current treatment should be adjusted in response to a patient's evolving health status. It is standard to define a regime as optimal if, when applied to a population of interest, it maximizes the mean of some desirable clinical outcome, such as efficacy. However, in many clinical settings, a high-quality treatment regime must balance multiple competing outcomes; eg, when a high dose is associated with substantial symptom reduction but a greater risk of an adverse event. We consider the problem of estimating the most efficacious

SUBMITTER: Laber EB 

PROVIDER: S-EPMC6293986 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature