DOUBLY ROBUST ESTIMATION OF OPTIMAL TREATMENT REGIMES FOR SURVIVAL DATA-WITH APPLICATION TO AN HIV/AIDS STUDY.

TitleDOUBLY ROBUST ESTIMATION OF OPTIMAL TREATMENT REGIMES FOR SURVIVAL DATA-WITH APPLICATION TO AN HIV/AIDS STUDY.
Publication TypeJournal Article
Year of Publication2017
AuthorsJiang, Runchao, Wenbin Lu, Rui Song, Michael G. Hudgens, and Sonia Naprvavnik
JournalAnn Appl Stat
Volume11
Issue3
Pagination1763-1786
Date Published2017 Sep
ISSN1932-6157
Abstract

In many biomedical settings, assigning every patient the same treatment may not be optimal due to patient heterogeneity. Individualized treatment regimes have the potential to dramatically improve clinical outcomes. When the primary outcome is censored survival time, a main interest is to find optimal treatment regimes that maximize the survival probability of patients. Since the survival curve is a function of time, it is important to balance short-term and long-term benefit when assigning treatments. In this paper, we propose a doubly robust approach to estimate optimal treatment regimes that optimize a user specified function of the survival curve, including the restricted mean survival time and the median survival time. The empirical and asymptotic properties of the proposed method are investigated. The proposed method is applied to a data set from an ongoing HIV/AIDS clinical observational study conducted by the University of North Carolina (UNC) Center of AIDS Research (CFAR), and shows the proposed methods significantly improve the restricted mean time of the initial treatment duration. Finally, the proposed methods are extended to multi-stage studies.

DOI10.1214/17-AOAS1057
Alternate JournalAnn Appl Stat
Original PublicationDoubly robust estimation of optimal treatment regimes for survival data-with application to an HIV/AIDS study.
PubMed ID29308102
PubMed Central IDPMC5749433
Grant ListP01 CA142538 / CA / NCI NIH HHS / United States
P30 AI050410 / AI / NIAID NIH HHS / United States
R01 AI029168 / AI / NIAID NIH HHS / United States
R37 AI029168 / AI / NIAID NIH HHS / United States