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Publications (1)0 Total impact

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    ABSTRACT: In clinical practice, physicians make a series of treatment decisions over the course of a patient's disease based on his/her baseline and evolving characteristics. A dynamic treatment regime is a set of sequential decision rules that operationalizes this process. Each rule corresponds to a key decision point and dictates the next treatment action among the options available as a function of accrued information on the patient. Using data from a clinical trial or observational study, a key goal is estimating the optimal regime, that, if followed by the patient population, would yield the most favorable outcome on average. Q-learning and advantage (A-)learning are two main approaches for this purpose. We provide a detailed account of Q- and A-learning and study systematically the performance of these methods. The methods are illustrated using data from a study of depression.
    02/2012;