A Markovian decision model of adaptive cancer treatment and quality of life
Résumé
This paperdevelopsandanalyzesaMarkovchainmodelforthetreatmentofcancer.
Cancer therapyismodeledasthepatient'sMarkovDecisionProblem,withtheobjectiveof
maximizing thepatient'sdiscountedexpectedqualityoflifeyears.Patientsmakedecisions
on thedurationoftherapybasedontheprogressionofthediseaseaswellastheirown
preferences. Weobtainapowerfulanalyticdecisiontoolthroughwhichpatientsmay
select theirpreferredtreatmentstrategy.Weillustratethetradeospatientsarefacing
in anumericalexampleandcalculatethevaluelosttoacohortwhochoosesuboptimal
strategies. Inasecondmodelpatientsmaymakechoicestoincludedrugholidays.By
delayingtherapy,thepatienttemporarilyforgoesthegainsoftherapyinordertodelay
its sideeects.Weobtainananalytictoolthatallowsnumericalapproximationsofthe
optimal timesofdelay.
Domaines
Economies et finances
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