Abstract #300549

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JSM 2003 Abstract #300549
Activity Number: 71
Type: Invited
Date/Time: Monday, August 4, 2003 : 8:30 AM to 10:20 AM
Sponsor: IMS
Abstract - #300549
Title: Issues in Designing Dynamic Treatment Regimes
Author(s): Susan A. Murphy*+
Companies: University of Michigan
Address: Survey Research Center Room 2038, Ann Arbor, MI, 48106-1248,
Keywords: multistage decisions
Abstract:

Dynamic treatment regimes are individually tailored treatments that provide treatment to individuals only when and if they need the treatment and adjust the level of treatment to the individual's need. These treatment strategies are particularly suitable for the management of chronic, relapsing disorders such as alcohol and drug addiction, management of depression, and maintenance of weight loss. In a dynamic regime, decision rules (e.g., practice guidelines) for how the treatment level and type should vary with time are specified prior to the beginning of treatment; these rules use time varying measurements of subject-specific risk and progress to determine treatment level and type. We discuss traditional experimental methods used to construct the decision rules and explicate the implicit causal assumptions behind such traditional methods. We discuss when scenarios in which these assumptions are nontenable and propose alternate experimental methods.

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