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A Markovian decision model of adaptive cancer treatment and quality of life

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  • Peter Bayer

    (TSE-R - Toulouse School of Economics - UT Capitole - Université Toulouse Capitole - UT - Université de Toulouse - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)

  • Joel Steven Brown
  • Johan Dubbeldam
  • Mark Broom

Abstract

This paperdevelopsandanalyzesaMarkovchainmodelforthetreatmentofcancer. Cancer therapyismodeledasthepatient'sMarkovDecisionProblem,withtheobjectiveof maximizing thepatient'sdiscountedexpectedqualityoflifeyears.Patientsmakedecisions on thedurationoftherapybasedontheprogressionofthediseaseaswellastheirown preferences. Weobtainapowerfulanalyticdecisiontoolthroughwhichpatientsmay select theirpreferredtreatmentstrategy.Weillustratethetradeo spatientsarefacing in anumericalexampleandcalculatethevaluelosttoacohortwhochoosesuboptimal strategies. Inasecondmodelpatientsmaymakechoicestoincludedrugholidays.By delayingtherapy,thepatienttemporarilyforgoesthegainsoftherapyinordertodelay its sidee ects.Weobtainananalytictoolthatallowsnumericalapproximationsofthe optimal timesofdelay.

Suggested Citation

  • Peter Bayer & Joel Steven Brown & Johan Dubbeldam & Mark Broom, 2022. "A Markovian decision model of adaptive cancer treatment and quality of life," Working Papers hal-03542494, HAL.
    • Handle: RePEc:hal:wpaper:hal-03542494
    Note: View the original document on HAL open archive server: https://hal.science/hal-03542494
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    2. K. Le Lay & E. Myon & S. Hill & L. Riou-Franca & D. Scott & M. Sidhu & D. Dunlop & R. Launois, 2007. "Comparative cost-minimisation of oral and intravenous chemotherapy for first-line treatment of non-small cell lung cancer in the UK NHS system," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(2), pages 145-151, June.
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    4. Gilbar, Ora, 1991. "The quality of life of cancer patients who refuse chemotherapy," Social Science & Medicine, Elsevier, vol. 32(12), pages 1337-1340, January.
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