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

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  • Brown, Joel
  • Dubbeldam, Johan
  • Broom, Mark
  • Bayer, Péter

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.
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Suggested Citation

  • Brown, Joel & Dubbeldam, Johan & Broom, Mark & Bayer, Péter, 2022. "A Markovian decision model of adaptive cancer treatment and quality of life," TSE Working Papers 22-1291, Toulouse School of Economics (TSE).
    • Handle: RePEc:tse:wpaper:126508
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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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