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A Markovian decision model of adaptive cancer treatment and quality of life

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  • Brown, Joel
  • Dubbeldam, Johan
  • Broom, Mark
  • Bayer, Péter

Abstract

This paperdevelopsandanalyzesaMarkovchainmodelforthetreatmentofcancer. Cancer therapyismodeledasthepatient'sMarkovDecisionProblem,withtheobjectiveof maximizing thepatient'sdiscountedexpectedqualityoflifeyears.Patientsmakedecisions on thedurationoftherapybasedontheprogressionofthediseaseaswellastheirown preferences. Weobtainapowerfulanalyticdecisiontoolthroughwhichpatientsmay select theirpreferredtreatmentstrategy.Weillustratethetradeo spatientsarefacing in anumericalexampleandcalculatethevaluelosttoacohortwhochoosesuboptimal strategies. Inasecondmodelpatientsmaymakechoicestoincludedrugholidays.By delayingtherapy,thepatienttemporarilyforgoesthegainsoftherapyinordertodelay its sidee ects.Weobtainananalytictoolthatallowsnumericalapproximationsofthe optimal timesofdelay.
(This abstract was borrowed from another version of this item.)

Suggested Citation

  • Brown, Joel & Dubbeldam, Johan & Broom, Mark & Bayer, Péter, 2022. "A Markovian decision model of adaptive cancer treatment and quality of life," TSE Working Papers 22-1291, Toulouse School of Economics (TSE).
    • Handle: RePEc:tse:wpaper:126508
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    References listed on IDEAS

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    2. K. Le Lay & E. Myon & S. Hill & L. Riou-Franca & D. Scott & M. Sidhu & D. Dunlop & R. Launois, 2007. "Comparative cost-minimisation of oral and intravenous chemotherapy for first-line treatment of non-small cell lung cancer in the UK NHS system," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(2), pages 145-151, June.
    3. Nicola J. Cooper & Keith R. Abrams & Alex J. Sutton & David Turner & Paul C. Lambert, 2003. "A Bayesian approach to Markov modelling in cost‐effectiveness analyses: application to taxane use in advanced breast cancer," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 166(3), pages 389-405, October.
    4. Gilbar, Ora, 1991. "The quality of life of cancer patients who refuse chemotherapy," Social Science & Medicine, Elsevier, vol. 32(12), pages 1337-1340, January.
    5. Nicola J. Cooper & Alex J. Sutton & Keith R. Abrams & David Turner & Allan Wailoo, 2004. "Comprehensive decision analytical modelling in economic evaluation: a Bayesian approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(3), pages 203-226, March.
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