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arXiv 2103.01802stat.MEcs.LG
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中位最佳治疗方案

Median Optimal Treatment Regimes

Carnegie Mellon University(卡内基梅隆大学)

Liu Leqi, Edward H. Kennedy

摘要:

最佳治疗方案是基于受试者特征做出治疗决策的个性化策略,其中选择的策略使某些值最大化。通常的目标是最大限度地提高人群的平均结局,通过一种方案,仅将治疗分配给治疗组与对照组相比平均结局更高的患者。然而,平均值可能是一个不稳定的中心性指标,导致不精确的统计程序,以及不稳健的决策,可能会受到一小部分受试者的过度影响。在这项工作中,我们提出了一个新的中位数最佳治疗方案,而不是治疗条件中位数较高的个人治疗。这确保了来自同一组的个体的最佳决策不会受到(i)该组的一小部分(与平均值标准不同)或(ii)来自不同组的无关受试者(与边际中位数/分位数标准不同)的过度影响。我们引入了一个新的价值衡量标准,平均条件中位数效应(ACME),它总结了一个政策的跨组中位数治疗结果,以及中位数最佳治疗方案最大化。开发关键激励的例子,区分中位数最优治疗方案的平均值和边际中位数最优治疗方案后,我们给出了一个非参数的效率界估计的ACME的政策,并提出了一个新的双重鲁棒风格的估计,实现弱条件下的效率界。为了构造中位最优治疗方案,我们引入了一个新的双稳健型估计的条件中位数处理效应。通过数值模拟和所提出的算法说明了随机临床试验中的数据与艾滋病毒感染者的样本属性进行了探讨。

英文摘要:

Optimal treatment regimes are personalized policies for making a treatment decision based on subject characteristics, with the policy chosen to maximize some value. It is common to aim to maximize the mean outcome in the population, via a regime assigning treatment only to those whose mean outcome is higher under treatment versus control. However, the mean can be an unstable measure of centrality, resulting in imprecise statistical procedures, as well as unrobust decisions that can be overly influenced by a small fraction of subjects. In this work, we propose a new median optimal treatment regime that instead treats individuals whose conditional median is higher under treatment. This ensures that optimal decisions for individuals from the same group are not overly influenced either by (i) a small fraction of the group (unlike the mean criterion), or (ii) unrelated subjects from different groups (unlike marginal median/quantile criteria). We introduce a new measure of value, the Average Conditional Median Effect (ACME), which summarizes across-group median treatment outcomes of a policy, and which the median optimal treatment regime maximizes. After developing key motivating examples that distinguish median optimal treatment regimes from mean and marginal median optimal treatment regimes, we give a nonparametric efficiency bound for estimating the ACME of a policy, and propose a new doubly robust-style estimator that achieves the efficiency bound under weak conditions. To construct the median optimal treatment regime, we introduce a new doubly robust-style estimator for the conditional median treatment effect. Finite-sample properties are explored via numerical simulations and the proposed algorithm is illustrated using data from a randomized clinical trial in patients with HIV.

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

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