Estimation and extrapolation of optimal treatment and testing strategies

Robins,J, Orellana,L and Rotnitzky,A 2008, Estimation and extrapolation of optimal treatment and testing strategies, Statistics in medicine, vol. 27, no. 23, pp. 4678-4721, doi: 10.1002/sim.3301.

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Title Estimation and extrapolation of optimal treatment and testing strategies
Author(s) Robins,J
Orellana,LORCID iD for Orellana,L
Journal name Statistics in medicine
Volume number 27
Issue number 23
Start page 4678
End page 4721
Total pages 44
Publisher Wiley
Place of publication London, Eng.
Publication date 2008-10-15
ISSN 0277-6715
Keyword(s) Causal inference
Dynamic regime
Marginal structural model
Value of information
Summary We review recent developments in the estimation of an optimal treatment strategy or regime from longitudinal data collected in an observational study. We also propose novel methods for using the data obtained from an observational database in one health-care system to determine the optimal treatment regime for biologically similar subjects in a second health-care system when, for cultural, logistical, or financial reasons, the two health-care systems differ (and will continue to differ) in the frequency of, and reasons for, both laboratory tests and physician visits. Finally, we propose a novel method for estimating the optimal timing of expensive and/or painful diagnostic or prognostic tests. Diagnostic or prognostic tests are only useful in so far as they help a physician to determine the optimal dosing strategy, by providing information on both the current health state and the prognosis of a patient because, in contrast to drug therapies, these tests have no direct causal effect on disease progression. Our new method explicitly incorporates this no direct effect restriction.
Language eng
DOI 10.1002/sim.3301
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2008, Wiley-Blackwell
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Document type: Journal Article
Collection: Faculty of Health
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