期刊
ELECTRONIC JOURNAL OF STATISTICS
卷 8, 期 -, 页码 1225-1273出版社
INST MATHEMATICAL STATISTICS
DOI: 10.1214/14-EJS920
关键词
Personalized medicine; data-driven decision making; nonregular inference; adaptive confidence intervals
资金
- NIH [P01 CA142538]
- PR Department of Natural and Environmental Resources (PRDNER) [PR-W-F14AF00171]
- Natural Sciences and Engineering Research Council of Canada
- NSF [DMS-1307838]
- NIMH [R01-MH-080015]
- NIDA [P50-DA-010075]
- EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT [R01HD073975] Funding Source: NIH RePORTER
- NATIONAL CANCER INSTITUTE [P01CA142538] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING [U54EB020404] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF MENTAL HEALTH [R01MH080015, R01MH099898] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON DRUG ABUSE [P50DA010075] Funding Source: NIH RePORTER
Dynamic treatment regimes are of growing interest across the clinical sciences because these regimes provide one way to operationalize and thus inform sequential personalized clinical decision making. Formally, a dynamic treatment regime is a sequence of decision rules, one per stage of clinical intervention. Each decision rule maps up-to-date patient information to a recommended treatment. We briefly review a variety of approaches for using data to construct the decision rules. We then review a critical inferential challenge that results from nonregularity, which often arises in this area. In particular, nonregularity arises in inference for parameters in the optimal dynamic treatment regime; the asymptotic, limiting, distribution of estimators are sensitive to local perturbations. We propose and evaluate a locally consistent Adaptive Confidence Interval (ACI) for the parameters of the optimal dynamic treatment regime. We use data from the Adaptive Pharmacological and Behavioral Treatments for Children with ADHD Trial as an illustrative example. We conclude by highlighting and discussing emerging theoretical problems in this area.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据