UCL logo

UCL Discovery

UCL home » Library Services » Electronic resources » UCL Discovery

Designing Personalized Treatment: An Application to Anticoagulation Therapy

Ibrahim, R; Verter, V; Kucukyazici, B; Gendreau, M; Bolstein, M; (2016) Designing Personalized Treatment: An Application to Anticoagulation Therapy. Production and Operations Management , 25 (5) pp. 902-918. 10.1111/poms.12514. Green open access

[img]
Preview
Text
WarfarinDraft_R3.pdf

Download (376kB) | Preview

Abstract

In this study, we develop an analytical framework for personalizing the anticoagulation therapy of patients who are taking warfarin. Consistent with medical practice, our treatment design consists of two stages: (i) the initiation stage, modeled using a partially-observable Markov decision process, during which the physician learns through systematic belief updates about the unobservable patient sensitivity to warfarin, and (ii) the maintenance stage, modeled using a Markov decision process, during which the physician relies on his formed belief about patient sensitivity to determine the stable, patient-specific, warfarin dose to prescribe. We develop an expression for belief updates in the POMDP, establish the optimality of the myopic policy for the MDP, and derive conditions for the existence and uniqueness of a myopically optimal dose. We validate our models using a real-life patient data set gathered at the Hematology Clinic of the Jewish General Hospital in Montreal. The proposed analytical framework and case study enable us to develop useful clinical insights, for example, concerning the length of the initiation period and the importance of correctly assessing patient sensitivity.

Type: Article
Title: Designing Personalized Treatment: An Application to Anticoagulation Therapy
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/poms.12514
Publisher version: http://dx.doi.org/10.1111/poms.12514
Language: English
Additional information: This is the peer reviewed version of the following article: Ibrahim, R; Verter, V; Kucukyazici, B; Gendreau, M; Bolstein, M; (2015) Designing personalized Treatment: An Application to Anticoagulation Therapy. Production and Operations Management 10.1111/poms.12514., which has been published in final form at http://dx.doi.org/10.1111/poms.12514. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Keywords: personalized treatment; stroke prevention; treatment design; warfarin
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > UCL School of Management
URI: http://discovery.ucl.ac.uk/id/eprint/1471576
Downloads since deposit
64Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item