|
|||||
|
|
Timing of testing and treatment for asymptomatic diseases |
|
| Authors: | Eser K?rk?zlar Daniel M Faissol |
| Institution: | a State University of New York - Binghamton, School of Management, P.O. Box 6000, Binghamton, NY 13902, USA b Lawrence Livermore National Laboratory,1LLNL-JRNL-418038. Lawrence Livermore National Laboratory is operated by Lawrence Livermore National Security, LLC, for the U.S. Department of Energy, National Nuclear Security Administration under Contract DE-AC52-07NA27344.1 CA, USA c Pennsylvania State University - University Park, PA, USA d Georgia Institute of Technology, GA, USA |
| Abstract: | Many papers in the medical literature analyze the cost-effectiveness of screening for diseases by comparing a limited number of a priori testing policies under estimated problem parameters. However, this may be insufficient to determine the best timing of the tests or incorporate changes over time. In this paper, we develop and solve a Markov Decision Process (MDP) model for a simple class of asymptomatic diseases in order to provide the building blocks for analysis of a more general class of diseases. We provide a computationally efficient method for determining a cost-effective dynamic intervention strategy that takes into account (i) the results of the previous test for each individual and (ii) the change in the individual’s behavior based on awareness of the disease. We demonstrate the usefulness of the approach by applying the results to screening decisions for Hepatitis C (HCV) using medical data, and compare our findings to current HCV screening recommendations. |
| Keywords: | Disease modeling Markov decision processes Asymptomatic diseases Disease screening and intervention Hepatitis C |
| 本文献已被 ScienceDirect 等数据库收录！ | |