期刊
BIOMETRICAL JOURNAL
卷 61, 期 2, 页码 442-453出版社
WILEY
DOI: 10.1002/bimj.201700181
关键词
adaptive treatment strategy; cure-rate; dynamic treatment regime; survival data; Q-learning
资金
- Canadian Institutes of Health Research [AO2-151569]
Cancers treated by transplantation are often curative, but immunosuppressive drugs are required to prevent and (if needed) to treat graft-versus-host disease. Estimation of an optimal adaptive treatment strategy when treatment at either one of two stages of treatment may lead to a cure has not yet been considered. Using a sample of 9563 patients treated for blood and bone cancers by allogeneic hematopoietic cell transplantation drawn from the Center for Blood and Marrow Transplant Research database, we provide a case study of a novel approach to Q-learning for survival data in the presence of a potentially curative treatment, and demonstrate the results differ substantially from an implementation of Q-learning that fails to account for the cure-rate.
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