Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Science

Program

Statistics and Actuarial Sciences

Collaborative Specialization

Biostatistics

Supervisor

He, Wenqing

Abstract

Dynamic treatment regimes are sequential decision rules dictating how to individualize treatments to patients based on evolving treatments and covariate history. In this thesis, we investigate two methods of estimating dynamic treatment regimes. The first method extends outcome weighted learning from two-treatments to multi-treatments and allows for negative treatment outcome. We show that under two different sets of assumptions, the Fisher consistency can be maintained. The second method estimates treatment rules by a neural classification tree. A weighted squared loss function is defined to approximate the indicator function to maintain the smoothness. A method of tree reconstruction and pruning is proposed to increase the interpretability. Simulation studies and real application to data from Sequential Treatment Alternatives to Relieve Depression (STAR*D) clinical trial are conducted to illustrate the proposed methods.

Summary for Lay Audience

Traditionally, treatments for patients are decided by clinical judgments based on clinician’s experience or practice guidelines based on clinical evidence and expert opinions. Patients with the same disease often receive the same treatment. It is one-size-fits-all approach. However, patient heterogeneity makes it possible that the best treatment for one patient is suboptimal for another. Therefore, it is important to make an transition from the traditional one-size-fits-all approach to individualized treatment rule which takes personal characteristics into account and tailors treatments to patients. This thesis will present two methods of identifying individualized treatment rule, called multicategory outcome weighted learning and neural classification tree.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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