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Abstract:

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. Copyright © 2008 John Wiley & Sons, Ltd.

Registro:

Documento: Artículo
Título:Estimation and extrapolation of optimal treatment and testing strategies
Autor:Robins, J.; Orellana, L.; Rotnitzky, A.
Filiación:Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States
FCEyN, Universidad de Buenos Aries, Buenos Aires, Argentina
Department of Economics, Di Tella University, Buenos Aires, Argentina
Department of Biostatistics, Harvard School of Public Health, Boston, MA, United States
Palabras clave:Causal inference; Dynamic regime; Marginal structural model; Value of information; antiretrovirus agent; CD4 lymphocyte count; clinical protocol; clinical trial; diagnostic test; drug response; health care system; health status; highly active antiretroviral therapy; human; Human immunodeficiency virus infection; medical information; observational study; prognosis; review; risk assessment; statistical analysis; statistical model; survival time; Antiretroviral Therapy, Highly Active; Bias (Epidemiology); Data Interpretation, Statistical; HIV Infections; Humans; Longitudinal Studies; Models, Statistical; Prognosis; Treatment Outcome
Año:2008
Volumen:27
Número:23
Página de inicio:4678
Página de fin:4721
DOI: http://dx.doi.org/10.1002/sim.3301
Título revista:Statistics in Medicine
Título revista abreviado:Stat. Med.
ISSN:02776715
CODEN:SMEDD
Registro:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_02776715_v27_n23_p4678_Robins

Referencias:

  • Palella, F.J., Deloria-Knoll, M., Chmiel, J.S., Moorman, A.C., Wood, K.C., Greenberg, A.E., Holmberg, S.D., HIV Outpatient Study (HOPS) Investigators. Survival benefit of initiating antiretroviral therapy in HIV-infected persons in different CD4+ cell strata (2003) Annals of Internal Medicine, 138, pp. 620-626
  • Orellana, L., Rotnitzky, A., Robins, J.M., Generalized marginal structural models for estimating optimal treatment regimes (2006), Technical Report, Department of Biostatistics, Harvard School of Public Health; van der Laan MJ. Causal effect models for intention to treat and realistic individualized treatment rules. Working Paper 203, U.C. Berkeley Division of Biostatistics Working Paper Series, 2006. (Available from: http://www.bepress.com/ucbbiostat/paper203.); Robins, J.M., Optimal structural nested models for optimal sequential decisions (2004) Proceedings of the Second Seattle Symposium on Biostatistics, , Lin DY, Heagerty P eds, Springer: New York
  • Murphy, S.A., Optimal dynamic treatment regimes (2003) Journal of the Royal Statistical Society, Series B, 65, pp. 331-366
  • Moodie, E.E.M., Richardson, T.S., Stephens, D., Demystifying optimal dynamic treatment regimes (2007) Biometrics, 63 (2), pp. 447-455
  • Hernán, M.A., Lanoy, E., Costagliola, D., Robins, J.M., Comparison of dynamic treatment regimes via inverse probability weighting (2006) Basic and Clinical Pharmacology and Toxicology, 98, pp. 237-242
  • Lanoy, M., Mary-Krause, P., Tattevin, R., Dray-Spira, C., Duvivier, P., Fischer, Y., Obadia, F., Costagliola, C., the Clinical Epidemiology Group. Predictors identified for losses to follow-up among HIV-seropositive patients (2006) Journal of Clinical Epidemiology, 59 (8), pp. 829-835
  • Robins, J.M., Marginal structural models versus structural nested models as tools for causal inference (1999) Statistical Models in Epidemiology: The Environment and Clinical Trials, pp. 95-134. , Halloran ME, Berry D eds, Springer: New York
  • Robins, J.M., Correcting for non-compliance in randomized trials using structural nested mean models (1994) Communications in Statistics, 23, pp. 2379-2412
  • Scharfstein, D., Rotnitzky, A., Robins, J.M., Adjusting for non-ignorable drop-out using semiparametric non-response models (1999) Journal of the American Statistical Association, 94, pp. 1096-1120
  • Robins, J.M., Sued, M., Lei-Gomez, Q., Rotnitzky, A., Performance of double-robust estimators when 'inverse probability' weights are highly variable. Discussion of demystifying double robustness: A comparison of alternative strategies for estimating a population mean from incomplete data, by Kang and Schaffer (2007) Statistical Science, , in press
  • Wang Y, Petersen M, Bangsberg D, van der Laan M. Diagnosing bias in the inverse probability of treatment weighted estimator resulting from violation of experimental treatment assignment. U. C. Berkeley Division of Biostatistics Working Paper Series, 2006. (Available from: http://www.bepress.com/ucbbiostat/paper211/.); Robins, J.M., Rotnitzky, A., Recovery of information and adjustment for dependent censoring using surrogate markers (1992) AIDS Epidemiology - Methodological Issues, pp. 297-331. , eds, Birkhäuser: Boston, MA, includes errata sheet
  • Robins, J.M., Scharfstein, D., Rotnitzky, A., Sensitivity analysis for selection bias and unmeasured confounding in missing data and causal inference models (1999) Statistical Models in Epidemiology: The Environment and Clinical Trials, pp. 1-94. , Halloran ME, Beny D eds, Springer: New York

Citas:

---------- APA ----------
Robins, J., Orellana, L. & Rotnitzky, A. (2008) . Estimation and extrapolation of optimal treatment and testing strategies. Statistics in Medicine, 27(23), 4678-4721.
http://dx.doi.org/10.1002/sim.3301
---------- CHICAGO ----------
Robins, J., Orellana, L., Rotnitzky, A. "Estimation and extrapolation of optimal treatment and testing strategies" . Statistics in Medicine 27, no. 23 (2008) : 4678-4721.
http://dx.doi.org/10.1002/sim.3301
---------- MLA ----------
Robins, J., Orellana, L., Rotnitzky, A. "Estimation and extrapolation of optimal treatment and testing strategies" . Statistics in Medicine, vol. 27, no. 23, 2008, pp. 4678-4721.
http://dx.doi.org/10.1002/sim.3301
---------- VANCOUVER ----------
Robins, J., Orellana, L., Rotnitzky, A. Estimation and extrapolation of optimal treatment and testing strategies. Stat. Med. 2008;27(23):4678-4721.
http://dx.doi.org/10.1002/sim.3301