2012
DOI: 10.1287/msom.1120.0388
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Optimization of Prostate Biopsy Referral Decisions

Abstract: Prostate cancer is the most common solid tumor in American men and is screened for using prostate-specific antigen (PSA) tests. We report on a non-stationary partially observable Markov decision process (POMDP) for prostate biopsy referral decisions. The core states are the patients' prostate cancer related health states, and PSA test results are the observations. Transition probabilities and rewards are inferred from the Mayo Clinic Radical Prostatectomy Registry (MCRPR) and the medical literature. The object… Show more

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Cited by 78 publications
(70 citation statements)
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“…Ayer et al (2012) and Maillart et al (2008) develop a POMDP and hidden Markov chain for mammography screening for breast cancer, and Zhang et al (2012b) propose a POMDP model for screening for prostate cancer. In addition, Zhang et al (2012a) develop another POMDP application to determine the optimal timing of biopsy based on annual prostate-specific antigen test results. There are no biopsy decisions in colonoscopy screening because the lesions detected by colonoscopy are always removed.…”
Section: Literature Reviewmentioning
confidence: 99%
“…Ayer et al (2012) and Maillart et al (2008) develop a POMDP and hidden Markov chain for mammography screening for breast cancer, and Zhang et al (2012b) propose a POMDP model for screening for prostate cancer. In addition, Zhang et al (2012a) develop another POMDP application to determine the optimal timing of biopsy based on annual prostate-specific antigen test results. There are no biopsy decisions in colonoscopy screening because the lesions detected by colonoscopy are always removed.…”
Section: Literature Reviewmentioning
confidence: 99%
“…Optimization methods have only recently begun to be applied to outcomes research problems such as finding the optimal treatment pathway for a particular type of patient within constraints imposed by the system (insurance coverage, access to certain types of facilities, etc.) [82]. In either case, it is apparent that dynamic simulation models would be an important precursor to optimization, greatly improving our understanding of the system necessary to formulate the optimization problem.…”
Section: Areas For Continued Methodological Development Applying Dynamentioning
confidence: 99%
“…Lee et al (2008) used a simulation-based approximate dynamic programming algorithm to derive near-optimal strategies for initiation and management of dialysis therapy. Zhang et al (2012) investigated the problem of optimal prostate biopsy referral decisions and proved Downloaded from informs.org by [129.93.16.3] on 06 October 2015, at 15:25 . For personal use only, all rights reserved.…”
Section: Optimal Timing Of Medical Interventionsmentioning
confidence: 99%