Data-Driven Markov Decision Process Approximations for Personalized Hypertension Treatment Planning
| Autor: | Rodney A. Hayward, Jeremy B. Sussman, Wesley J. Marrero, Mariel S. Lavieri, Greggory J. Schell |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Mathematical optimization
Computer science Markov models 030204 cardiovascular system & hematology Markov model Poisson distribution computer.software_genre 03 medical and health sciences symbols.namesake 0302 clinical medicine 030212 general & internal medicine Poisson regression Interpretability lcsh:R5-920 decision rules decision support techniques Markov chain business.industry Health Policy Public Health Environmental and Occupational Health Usability Decision rule 3. Good health provider decision making symbols Original Article Markov decision process Data mining business lcsh:Medicine (General) computer |
| Zdroj: | MDM Policy & Practice, Vol 1 (2016) MDM Policy & Practice |
| ISSN: | 2381-4683 |
| Popis: | Background: Markov decision process (MDP) models are powerful tools. They enable the derivation of optimal treatment policies but may incur long computational times and generate decision rules that are challenging to interpret by physicians. Methods: In an effort to improve usability and interpretability, we examined whether Poisson regression can approximate optimal hypertension treatment policies derived by an MDP for maximizing a patient’s expected discounted quality-adjusted life years. Results: We found that our Poisson approximation to the optimal treatment policy matched the optimal policy in 99% of cases. This high accuracy translates to nearly identical health outcomes for patients. Furthermore, the Poisson approximation results in 104 additional quality-adjusted life years per 1000 patients compared to the Seventh Joint National Committee’s treatment guidelines for hypertension. The comparative health performance of the Poisson approximation was robust to the cardiovascular disease risk calculator used and calculator calibration error. Limitations: Our results are based on Markov chain modeling. Conclusions: Poisson model approximation for blood pressure treatment planning has high fidelity to optimal MDP treatment policies, which can improve usability and enhance transparency of more personalized treatment policies. |
| Databáze: | OpenAIRE |
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