Optimal testing policies for diagnosing patients with intermediary probability of disease

Arruda, Edilson F.; Pereira, Basílio de Bragança; Thiers, Clarissa Antunes; Tura, Bernardo Rangel

doi:10.1016/j.artmed.2018.11.005

Cited by 6 publications

(2 citation statements)

References 15 publications

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“…Regarding decision-making on CHD, while there have been many studies that focus on the optimal screening policies [ 31 , 32 ] and treatment policies [ 33 , 34 , 35 , 36 ], there have been relatively few studies that focus on improving CHD diagnosis based on quantitative trade-offs. On the other hand, it is worth noting that the heterogeneity of patients is of paramount importance in making decisions [ 2 , 29 , 37 ].…”

Section: Literature Reviewmentioning

confidence: 99%

Diagnostic Policies Optimization for Chronic Diseases Based on POMDP Model

Zhang

Wang

2022

Healthcare

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During the process of disease diagnosis, overdiagnosis can lead to potential health loss and unnecessary anxiety for patients as well as increased medical costs, while underdiagnosis can result in patients not being treated on time. To deal with these problems, we construct a partially observable Markov decision process (POMDP) model of chronic diseases to study optimal diagnostic policies, which takes into account individual characteristics of patients. The objective of our model is to maximize a patient’s total expected quality-adjusted life years (QALYs). We also derive some structural properties, including the existence of the diagnostic threshold and the optimal diagnosis age for chronic diseases. The resulting optimization is applied to the management of coronary heart disease (CHD). Based on clinical data, we validate our model, demonstrate how the quantitative tool can provide actionable insights for physicians and decision makers in health-related fields, and compare optimal policies with actual clinical decisions. The results indicate that the diagnostic threshold first decreases and then increases as the patient’s age increases, which contradicts the intuitive non-decreasing thresholds. Moreover, diagnostic thresholds were higher for women than for men, especially at younger ages.

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Section: Literature Reviewmentioning

confidence: 99%

Diagnostic Policies Optimization for Chronic Diseases Based on POMDP Model

Zhang

Wang

2022

Healthcare

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“…In this paper, we model blood inventory as a Markov decision process -MDP. MDPs are designed for sequential decision making under uncertainty (Puterman, 2014), hence their frequent use in medical applications (e.g., Andersen et al, 2019;Arruda et al, 2019;Steimle and Denton, 2017;Bennett and Hauser, 2013;Alagoz et al, 2010) and in blood inventory problems (e.g., Attari et al, 2019b;Hosseinifard et al, 2019). The use of an MDP ensures more flexibility as it allows an optimal decision for each available state, while also ensuring optimality in the long run.…”

Section: Mathematical Formulationmentioning

confidence: 99%

Optimisation and control of the supply of blood bags in hemotherapic centres via Markov decision process with discounted arrival rate

Soares

Arruda

Bahiense

et al. 2020

Artificial Intelligence in Medicine

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Running a cost-effective human blood transfusion supply chain challenges decision makers in blood services world-wide. In this paper, we develop a Markov decision process with the objective of minimising the overall costs of internal and external collections, storing, producing and disposing of blood bags, whilst explicitly considering the probability that a donated blog bag will perish before demanded. The model finds an optimal policy to collect additional bags based on the number of bags in stock rather than using information about the age of the oldest item. Using data from the literature, we validate our model and carry out a case study based on data from a large blood supplier in South America. The study helped achieve an overall increase of 4.5% in blood donations in one year.

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Social Risk Analysis of Smart Grid Based on Emerging Technologies in the Chinese Context: A Review Based on CiteSpace

Chen

Zhao

2023

Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering

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Optimal testing policies for diagnosing patients with intermediary probability of disease

Cited by 6 publications

References 15 publications

Diagnostic Policies Optimization for Chronic Diseases Based on POMDP Model

Diagnostic Policies Optimization for Chronic Diseases Based on POMDP Model

Optimisation and control of the supply of blood bags in hemotherapic centres via Markov decision process with discounted arrival rate

Social Risk Analysis of Smart Grid Based on Emerging Technologies in the Chinese Context: A Review Based on CiteSpace

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