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二元网络上的动态治疗方案

Dynamic Treatment Regimes on Dyadic Networks.

作者信息

Rizi Marizeh Mussavi, Dubin Joel A, Wallace Micheal P

机构信息

Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada.

出版信息

Stat Med. 2024 Dec 30;43(30):5944-5967. doi: 10.1002/sim.10278. Epub 2024 Nov 28.

Abstract

Identifying interventions that are optimally tailored to each individual is of significant interest in various fields, in particular precision medicine. Dynamic treatment regimes (DTRs) employ sequences of decision rules that utilize individual patient information to recommend treatments. However, the assumption that an individual's treatment does not impact the outcomes of others, known as the no interference assumption, is often challenged in practical settings. For example, in infectious disease studies, the vaccine status of individuals in close proximity can influence the likelihood of infection. Imposing this assumption when it, in fact, does not hold, may lead to biased results and impact the validity of the resulting DTR optimization. We extend the estimation method of dynamic weighted ordinary least squares (dWOLS), a doubly robust and easily implemented approach for estimating optimal DTRs, to incorporate the presence of interference within dyads (i.e., pairs of individuals). We formalize an appropriate outcome model and describe the estimation of an optimal decision rule in the dyadic-network context. Through comprehensive simulations and analysis of the Population Assessment of Tobacco and Health (PATH) data, we demonstrate the improved performance of the proposed joint optimization strategy compared to the current state-of-the-art conditional optimization methods in estimating the optimal treatment assignments when within-dyad interference exists.

摘要

在各个领域,尤其是精准医学中,确定最适合每个个体的干预措施具有重大意义。动态治疗方案(DTR)采用一系列决策规则,利用个体患者信息来推荐治疗方法。然而,个体治疗不会影响他人结果的假设,即无干扰假设,在实际情况中常常受到挑战。例如,在传染病研究中,近距离个体的疫苗接种状况会影响感染的可能性。在该假设实际上不成立时强行使用它,可能会导致有偏差的结果,并影响由此产生的DTR优化的有效性。我们扩展了动态加权普通最小二乘法(dWOLS)的估计方法,这是一种用于估计最优DTR的双重稳健且易于实现的方法,以纳入二元组(即个体对)内的干扰情况。我们形式化了一个合适的结果模型,并描述了在二元网络背景下最优决策规则的估计。通过全面的模拟以及对烟草与健康人口评估(PATH)数据的分析,我们证明了在存在二元组内干扰的情况下,与当前最先进的条件优化方法相比,所提出的联合优化策略在估计最优治疗分配方面具有更好的性能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acf4/11639660/7579c00ad26f/SIM-43-5944-g003.jpg

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