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arXiv 2202.09451stat.ME
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使用先导性数据确定动态治疗方案估计的观察性研究规模

Using Pilot Data to Size Observational Studies for the Estimation of Dynamic Treatment Regimes

Eric J. Rose, Erica E. M. Moodie, Susan Shortreed

摘要:

已经有显着的注意力给予开发数据驱动的方法,用于定制基于个体患者特征的患者护理。动态治疗方案通过将患者信息映射到建议治疗的一系列决策规则来形式化这一点。用于估计和评价治疗方案的数据理想地通过使用序贯多分配随机试验(SMART)收集,尽管由于进行SMART的潜在成本过高,通常使用纵向观察性研究。这些研究的规模通常是固定治疗序列的简单比较,或者在观察性研究的情况下,通常不进行先验样本量计算。我们开发了样本量程序,用于从观察性研究中估计动态治疗方案。我们的方法使用试点数据,以确保研究将有足够的把握度比较最佳方案的价值,即预期的结果,如果所有患者在人群中接受治疗后的最佳方案,与已知的比较平均值。我们的方法还确保了估计的最佳治疗方案的值在具有高概率的真实最佳方案的值的先验集合范围内。我们研究的性能与模拟研究的建议程序,并使用它来规模的研究,减少抑郁症状,使用电子健康记录的数据。

英文摘要:

There has been significant attention given to developing data-driven methods for tailoring patient care based on individual patient characteristics. Dynamic treatment regimes formalize this through a sequence of decision rules that map patient information to a suggested treatment. The data for estimating and evaluating treatment regimes are ideally gathered through the use of Sequential Multiple Assignment Randomized Trials (SMARTs) though longitudinal observational studies are commonly used due to the potentially prohibitive costs of conducting a SMART. These studies are typically sized for simple comparisons of fixed treatment sequences or, in the case of observational studies, a priori sample size calculations are often not performed. We develop sample size procedures for the estimation of dynamic treatment regimes from observational studies. Our approach uses pilot data to ensure a study will have sufficient power for comparing the value of the optimal regime, i.e. the expected outcome if all patients in the population were treated by following the optimal regime, with a known comparison mean. Our approach also ensures the value of the estimated optimal treatment regime is within an a priori set range of the value of the true optimal regime with a high probability. We examine the performance of the proposed procedure with a simulation study and use it to size a study for reducing depressive symptoms using data from electronic health records.

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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