title: A control systems engineering approach for adaptive behavioral interventions: illustration with a fibromyalgia intervention.
abstract: The term adaptive intervention has been used in behavioral medicine to describe operationalized and individually tailored strategies for prevention and treatment of chronic, relapsing disorders. Control systems engineering offers an attractive means for designing and implementing adaptive behavioral interventions that feature intensive measurement and frequent decision-making over time. This is illustrated in this paper for the case of a low-dose naltrexone treatment intervention for fibromyalgia. System identification methods from engineering are used to estimate dynamical models from daily diary reports completed by participants. These dynamical models then form part of a model predictive control algorithm which systematically decides on treatment dosages based on measurements obtained under real-life conditions involving noise, disturbances, and uncertainty. The effectiveness and implications of this approach for behavioral interventions (in general) and pain treatment (in particular) are demonstrated using informative simulations.
authors.affiliation: Control Systems Engineering Laboratory, School for Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, AZ 85287 USA.
authors.forename: Sunil
authors.initials: S
authors.lastname: Deshpande
authors.affiliation: Control Systems Engineering Laboratory, School for Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, AZ 85287 USA.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Rivera
authors.affiliation: Neuroinflammation, Pain and Fatigue Laboratory, Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294 USA.
authors.forename: Jarred W
authors.initials: JW
authors.lastname: Younger
authors.affiliation: Control Systems Engineering Laboratory, School for Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, AZ 85287 USA ; ABB Corporate Research Center, Bangalore, India.
authors.forename: Naresh N
authors.initials: NN
authors.lastname: Nandola
keywords: Adaptive behavioral interventions; Control systems engineering; Dynamical systems; Fibromyalgia; Model predictive control; Pain treatment; System identification