Optimal decision support rules improve personalize warfarin treatment outcomes

Chih Lin Chi, Kourosh Ravvaz, John Weissert, Peter J. Tonellato

Research output: Chapter in Book/Report/Conference proceedingConference contribution

1 Scopus citations

Abstract

We tested optimization-based approaches to generate decision support rules used to improve personalized warfarin treatment based on clinical and genetic characteristics. Our approach simulated warfarin treatment outcomes using five existing treatment plans for clinical avatars (virtual patients). We used individual clinical avatar Time-in-Therapeutic-Range to represent the two-sided adverse risk to bleeding (over dosed - above therapeutic range) and thrombosis (under dosed - below therapeutic range) and as the objective function in the optimization to minimize overall risk. A series of optimization approaches demonstrate that correctly selected decision rules matched to particularly characterized patients produce treatment plans that minimize risk. Finally, a decision tree algorithm was used to produce decision rules, each of which indicated a specific treatment plan that optimally reduce risks for a patient subgroup. The optimization approach minimizes entropy/impurity property thus producing rules that identify treatment plans that minimize overall adverse risks for the largest possible patient subgroups.

Original languageEnglish (US)
Title of host publication2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2016
PublisherInstitute of Electrical and Electronics Engineers Inc.
Pages2594-2597
Number of pages4
ISBN (Electronic)9781457702204
DOIs
StatePublished - Oct 13 2016
Event38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2016 - Orlando, United States
Duration: Aug 16 2016Aug 20 2016

Publication series

NameProceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS
Volume2016-October
ISSN (Print)1557-170X

Other

Other38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2016
CountryUnited States
CityOrlando
Period8/16/168/20/16

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