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General Identification of Dynamic Treatment Regimes Under Interference.

ABSTRACT: In many applied fields, researchers are often interested in tailoring treatments to unit-level characteristics in order to optimize an outcome of interest. Methods for identifying and estimating treatment policies are the subject of the dynamic treatment regime literature. Separately, in many settings the assumption that data are independent and identically distributed does not hold due to inter-subject dependence. The phenomenon where a subject's outcome is dependent on his neighbor's exposure is known as interference. These areas intersect in myriad real-world settings. In this paper we consider the problem of identifying optimal treatment policies in the presence of interference. Using a general representation of interference, via Lauritzen-Wermuth-Freydenburg chain graphs (Lauritzen and Richardson, 2002), we formalize a variety of policy interventions under interference and extend existing identification theory (Tian, 2008; Sherman and Shpitser, 2018). Finally, we illustrate the efficacy of policy maximization under interference in a simulation study.

SUBMITTER: Sherman ES

PROVIDER: S-EPMC7730527 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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General Identification of Dynamic Treatment Regimes Under Interference.

Sherman Eli S ES Arbour David D Shpitser Ilya I

Proceedings of machine learning research 20200801

In many applied fields, researchers are often interested in tailoring treatments to unit-level characteristics in order to optimize an outcome of interest. Methods for identifying and estimating treatment policies are the subject of the dynamic treatment regime literature. Separately, in many settings the assumption that data are independent and identically distributed does not hold due to inter-subject dependence. The phenomenon where a subject's outcome is dependent on his neighbor's exposure ...[more]

PMID: 33313513

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Project description:Precision medicine is currently a topic of great interest in clinical and intervention science. A key component of precision medicine is that it is evidence-based, i.e., data-driven, and consequently there has been tremendous interest in estimation of precision medicine strategies using observational or randomized study data. One way to formalize precision medicine is through a treatment regime, which is a sequence of decision rules, one per stage of clinical intervention, that map up-to-date patient information to a recommended treatment. An optimal treatment regime is defined as maximizing the mean of some cumulative clinical outcome if applied to a population of interest. It is well-known that even under simple generative models an optimal treatment regime can be a highly nonlinear function of patient information. Consequently, a focal point of recent methodological research has been the development of flexible models for estimating optimal treatment regimes. However, in many settings, estimation of an optimal treatment regime is an exploratory analysis intended to generate new hypotheses for subsequent research and not to directly dictate treatment to new patients. In such settings, an estimated treatment regime that is interpretable in a domain context may be of greater value than an unintelligible treatment regime built using 'black-box' estimation methods. We propose an estimator of an optimal treatment regime composed of a sequence of decision rules, each expressible as a list of "if-then" statements that can be presented as either a paragraph or as a simple flowchart that is immediately interpretable to domain experts. The discreteness of these lists precludes smooth, i.e., gradient-based, methods of estimation and leads to non-standard asymptotics. Nevertheless, we provide a computationally efficient estimation algorithm, prove consistency of the proposed estimator, and derive rates of convergence. We illustrate the proposed methods using a series of simulation examples and application to data from a sequential clinical trial on bipolar disorder.

Dataset Information

General Identification of Dynamic Treatment Regimes Under Interference.

Publications

General Identification of Dynamic Treatment Regimes Under Interference.

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