title: Comparing treatment policies with assistance from the structural nested mean model.
abstract: Treatment policies, also known as dynamic treatment regimes, are sequences of decision rules that link the observed patient history with treatment recommendations. Multiple, plausible, treatment policies are frequently constructed by researchers using expert opinion, theories, and reviews of the literature. Often these different policies represent competing approaches to managing an illness. Here, we develop an "assisted estimator" that can be used to compare the mean outcome of competing treatment policies. The term "assisted" refers to the fact estimators from the Structural Nested Mean Model, a parametric model for the causal effect of treatment at each time point, are used in the process of estimating the mean outcome. This work is motivated by our work on comparing the mean outcome of two competing treatment policies using data from the ExTENd study in alcohol dependence.
authors.affiliation: Department of Statistics, University of Michigan, Ann Arbor, Michigan 48109, U.S.A.
authors.forename: Xi
authors.initials: X
authors.lastname: Lu
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, U.S.A.
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Lynch
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, U.S.A.
authors.forename: David W
authors.initials: DW
authors.lastname: Oslin
authors.affiliation: Department of Statistics, University of Michigan, Ann Arbor, Michigan 48109, U.S.A.
authors.forename: Susan
authors.initials: S
authors.lastname: Murphy
mesh_terms: D000437:Alcoholism / Q000175:diagnosis / Q000517:prevention & control*; D000465:Algorithms; D003198:Computer Simulation; D003627:Data Interpretation, Statistical; D003657:Decision Making; D006801:Humans; D015233:Models, Statistical; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care / Q000379:methods*; D016032:Randomized Controlled Trials as Topic / Q000379:methods*
chemical_list: D009292:Narcotic Antagonists; D009271:Naltrexone
keywords: Adaptive intervention; Dynamic treatment regime; Semiparametric model; Sequential multiple assignment randomized trial