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Probabilistic threshold analysis by pairwise stochastic approximation for decision-making under uncertainty.

ABSTRACT: The concept of probabilistic parameter threshold analysis has recently been introduced as a way of probabilistic sensitivity analysis for decision-making under uncertainty, in particular, for health economic evaluations which compare two or more alternative treatments with consideration of uncertainty on outcomes and costs. In this paper we formulate the probabilistic threshold analysis as a root-finding problem involving the conditional expectations, and propose a pairwise stochastic approximation algorithm to search for the threshold value below and above which the choice of conditionally optimal decision options changes. Numerical experiments for both a simple synthetic testcase and a chemotherapy Markov model illustrate the effectiveness of our proposed algorithm, without any need for accurate estimation or approximation of conditional expectations which the existing approaches rely upon. Moreover we introduce a new measure called decision switching probability for probabilistic sensitivity analysis in this paper.

SUBMITTER: Goda T

PROVIDER: S-EPMC8490445 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Probabilistic threshold analysis by pairwise stochastic approximation for decision-making under uncertainty.

Goda Takashi T Yamada Yuki Y

Scientific reports 20211004 1

The concept of probabilistic parameter threshold analysis has recently been introduced as a way of probabilistic sensitivity analysis for decision-making under uncertainty, in particular, for health economic evaluations which compare two or more alternative treatments with consideration of uncertainty on outcomes and costs. In this paper we formulate the probabilistic threshold analysis as a root-finding problem involving the conditional expectations, and propose a pairwise stochastic approximat ...[more]

PMID: 34608224

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Project description:BackgroundStatistical inference based on small datasets, commonly found in precision oncology, is subject to low power and high uncertainty. In these settings, drawing strong conclusions about future research utility is difficult when using standard inferential measures. It is therefore important to better quantify the uncertainty associated with both significant and non-significant results based on small sample sizes.MethodsWe developed a new method, Bayesian Additional Evidence (BAE), that determines (1) how much additional supportive evidence is needed for a non-significant result to reach Bayesian posterior credibility, or (2) how much additional opposing evidence is needed to render a significant result non-credible. Although based in Bayesian analysis, a prior distribution is not needed; instead, the tipping point output is compared to reasonable effect ranges to draw conclusions. We demonstrate our approach in a comparative effectiveness analysis comparing two treatments in a real world biomarker-defined cohort, and provide guidelines for how to apply BAE in practice.ResultsOur initial comparative effectiveness analysis results in a hazard ratio of 0.31 with 95% confidence interval (0.09, 1.1). Applying BAE to this result yields a tipping point of 0.54; thus, an observed hazard ratio of 0.54 or smaller in a replication study would result in posterior credibility for the treatment association. Given that effect sizes in this range are not extreme, and that supportive evidence exists from a similar published study, we conclude that this problem is worthy of further research.ConclusionsOur proposed method provides a useful framework for interpreting analytic results from small datasets. This can assist researchers in deciding how to interpret and continue their investigations based on an initial analysis that has high uncertainty. Although we illustrated its use in estimating parameters based on time-to-event outcomes, BAE easily applies to any normally-distributed estimator, such as those used for analyzing binary or continuous outcomes.

Dataset Information

Probabilistic threshold analysis by pairwise stochastic approximation for decision-making under uncertainty.

Publications

Probabilistic threshold analysis by pairwise stochastic approximation for decision-making under uncertainty.

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