Dynamic Treatment Regimes.

Dynamic Treatment Regimes.
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DOI:
10.1146/annurev-statistics-022513-115553
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发表时间:
2014
影响因子:
7.9
通讯作者:
Murphy SA
Murphy SA
中科院分区:
数学1区
文献类型:
--
作者:
Chakraborty B;Murphy SA

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动态治疗方案由一系列决策规则组成,每个干预阶段一个,这些规则规定如何根据不断变化的治疗和协变量历史为患者提供个性化治疗。这些方案对于管理慢性疾病特别有用,并且很好地适应了个性化医疗的更大范例。他们提供了一种方法来操作临床决策支持系统。统计学在构建基于证据的动态治疗方案中起着关键作用-为最佳研究设计以及有效的估计和有效的推断提供信息。由于它提供了许多新的方法挑战,近年来这一领域在统计学家中越来越受欢迎。在这篇文章中,我们回顾了这一令人兴奋的研究领域的关键进展。特别是,我们讨论了序贯多重分配随机试验设计,估计技术,如Q-学习和边际结构模型,以及几个推理技术,旨在解决相关的非标准渐近。我们参考软件,只要可用。我们还概述了一些重要的未来方向。
A dynamic treatment regime consists of a sequence of decision rules, one per stage of intervention, that dictate how to individualize treatments to patients based on evolving treatment and covariate history. These regimes are particularly useful for managing chronic disorders, and fit well into the larger paradigm of personalized medicine. They provide one way to operationalize a clinical decision support system. Statistics plays a key role in the construction of evidence-based dynamic treatment regimes – informing best study design as well as efficient estimation and valid inference. Due to the many novel methodological challenges it offers, this area has been growing in popularity among statisticians in recent years. In this article, we review the key developments in this exciting field of research. In particular, we discuss the sequential multiple assignment randomized trial designs, estimation techniques like Q-learning and marginal structural models, and several inference techniques designed to address the associated non-standard asymptotics. We reference software, whenever available. We also outline some important future directions.
自适应设计中的概述,障碍和未来的工作:来自国立卫生研究院资助的研讨会的观点。
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