A Note on Estimating Optimal Dynamic Treatment Strategies Under Resource Constraints Using Dynamic Marginal Structural Models

التفاصيل البيبلوغرافية
العنوان: A Note on Estimating Optimal Dynamic Treatment Strategies Under Resource Constraints Using Dynamic Marginal Structural Models
المؤلفون: Caniglia, Ellen C, Murray, Eleanor J, Hernan, Miguel A, Shahn, Zach
سنة النشر: 2019
المجموعة: Quantitative Biology
Statistics
مصطلحات موضوعية: Statistics - Applications, Quantitative Biology - Populations and Evolution, Statistics - Methodology
الوصف: Existing strategies for determining the optimal treatment or monitoring strategy typically assume unlimited access to resources. However, when a health system has resource constraints, such as limited funds, access to medication, or monitoring capabilities, medical decisions must balance impacts on both individual and population health outcomes. That is, decisions should account for competition between individuals in resource usage. One simple solution is to estimate the (counterfactual) resource usage under the possible interventions and choose the optimal strategy for which resource usage is within acceptable limits. We propose a method to identify the optimal dynamic intervention strategy that leads to the best expected health outcome accounting for a health system's resource constraints. We then apply this method to determine the optimal dynamic monitoring strategy for people living with HIV when resource limits on monitoring exist using observational data from the HIV-CAUSAL Collaboration.
نوع الوثيقة: Working Paper
الوصول الحر: http://arxiv.org/abs/1903.06488Test
رقم الانضمام: edsarx.1903.06488
قاعدة البيانات: arXiv