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Estimation of optimal dynamic anticoagulation regimes from observational data: a regret‐based approach
Author(s) -
Rosthøj Susanne,
Fullwood Catherine,
Henderson Robin,
Stewart Syd
Publication year - 2006
Publication title -
statistics in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.996
H-Index - 183
eISSN - 1097-0258
pISSN - 0277-6715
DOI - 10.1002/sim.2694
Subject(s) - regret , observational study , term (time) , computer science , anticoagulant , econometrics , medicine , statistics , mathematics , machine learning , surgery , physics , quantum mechanics
A complication of long‐term anticoagulation is that the optimal dose level varies not only between patients but over time within patients, in response to short‐term changes in lifestyle. Consequently, doseage needs to be adaptive but there are as yet no accepted decision rules. Since anticoagulant use is increasing worldwide there is a need for more objective and routine procedures. In this paper, we describe an analysis of observational longitudinal anticoagulant data, aimed at determining an optimal reactive dose‐changing strategy. We use the regret parameterization approach advocated by Murphy ( J. R. Stat. Soc. Ser. B 2003; 65 :331–366). Practical problems encountered in the implementation of the approach are discussed and illustrated. Copyright © 2006 John Wiley & Sons, Ltd.