论文标题
学习个性化的治疗规则,具有估计翻译的反向倾向评分
Learning Individualized Treatment Rules with Estimated Translated Inverse Propensity Score
论文作者
论文摘要
随机对照试验通常分析治疗的有效性,目的是为患者亚组提出治疗建议。随着电子健康记录的发展,在临床实践中收集了大量数据,从而可以根据观察数据评估治疗和治疗政策。在本文中,我们专注于学习个性化的治疗规则(ITR),以得出一种治疗政策,该治疗政策有望为个别患者带来更好的结果。在我们的框架中,我们将ITR学习作为上下文匪徒问题,并最大程度地减少治疗政策的预期风险。我们在仿真研究和基于现实世界数据集中对拟议框架进行实验。在后一种情况下,我们采用我们提出的方法来学习用于静脉内(IV)液体和加速器(VP)的最佳ITR。基于各种离线评估方法,我们可以证明与医师和其他基线相比,我们框架中得出的政策表现出更好的表现,包括简单的治疗预测方法。作为一个长期目标,我们的派生政策最终可能会为iV和VP的管理提供更好的临床准则。
Randomized controlled trials typically analyze the effectiveness of treatments with the goal of making treatment recommendations for patient subgroups. With the advance of electronic health records, a great variety of data has been collected in clinical practice, enabling the evaluation of treatments and treatment policies based on observational data. In this paper, we focus on learning individualized treatment rules (ITRs) to derive a treatment policy that is expected to generate a better outcome for an individual patient. In our framework, we cast ITRs learning as a contextual bandit problem and minimize the expected risk of the treatment policy. We conduct experiments with the proposed framework both in a simulation study and based on a real-world dataset. In the latter case, we apply our proposed method to learn the optimal ITRs for the administration of intravenous (IV) fluids and vasopressors (VP). Based on various offline evaluation methods, we could show that the policy derived in our framework demonstrates better performance compared to both the physicians and other baselines, including a simple treatment prediction approach. As a long-term goal, our derived policy might eventually lead to better clinical guidelines for the administration of IV and VP.