Abstract
| Original language | English |
|---|---|
| Title of host publication | Markov Decision Processes in Practice |
| Editors | Richard J. Boucherie, Nico M. van Dijk |
| Place of Publication | Cham |
| Publisher | Springer |
| Pages | 223-244 |
| Number of pages | 22 |
| ISBN (Electronic) | 978-3-319-47766-4 |
| ISBN (Print) | 978-3-319-47764-0 |
| DOIs | |
| Publication status | Published - Mar 2017 |
Publication series
| Name | International Series in Operations Research & Management Science |
|---|---|
| Publisher | Springer International Publishing |
| Volume | 248 |
| ISSN (Print) | 0884-8289 |
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Keywords
- Partially observable markov decision process
- Breast cancer
- Optimal policies
- Stratified follow-up
Cite this
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Stratified breast cancer follow-up using a partially observable Markov decision process. / Otten, J.W.M.; Witteveen, A.; Vliegen, I.M.H.; Siesling, S.; Timmer, J.B.; IJzerman, M.J.
Markov Decision Processes in Practice. ed. / Richard J. Boucherie; Nico M. van Dijk. Cham : Springer, 2017. p. 223-244 (International Series in Operations Research & Management Science; Vol. 248).Research output: Chapter in Book/Report/Conference proceeding › Chapter › Academic › peer-review
TY - CHAP
T1 - Stratified breast cancer follow-up using a partially observable Markov decision process
AU - Otten, J.W.M.
AU - Witteveen, A.
AU - Vliegen, I.M.H.
AU - Siesling, S.
AU - Timmer, J.B.
AU - IJzerman, M.J.
PY - 2017/3
Y1 - 2017/3
N2 - Frequency and duration of follow-up for patients with breast cancer is still under discussion. Current follow-up consists of annual mammography for the first five years after treatment and does not depend on the personal risk of developing a locoregional recurrence (LRR) or second primary tumor. Aim of this study is to gain insight in how to allocate resources for optimal and personal follow-up. We formulate a discrete-time Partially Observable Markov Decision Process (POMDP) with a finite horzion in which we aim to maximize the total expected number of quality-adjusted life years (QALYs). Transition probabilities were obtained from data from the Netherlands Cancer Registry (NCR). Twice a year the decision is made whether or not a mammography will be performed. Recurrent disease can be detected by both mammography or women themselves (self-detection). The optimal policies were determined for three risk categories based on differentiation of the primary tumor. Our results suggest a slightly more intensive follow-up for patients with a high risk and poorly differentiated tumor, and a less intensive schedule for the other risk groups.
AB - Frequency and duration of follow-up for patients with breast cancer is still under discussion. Current follow-up consists of annual mammography for the first five years after treatment and does not depend on the personal risk of developing a locoregional recurrence (LRR) or second primary tumor. Aim of this study is to gain insight in how to allocate resources for optimal and personal follow-up. We formulate a discrete-time Partially Observable Markov Decision Process (POMDP) with a finite horzion in which we aim to maximize the total expected number of quality-adjusted life years (QALYs). Transition probabilities were obtained from data from the Netherlands Cancer Registry (NCR). Twice a year the decision is made whether or not a mammography will be performed. Recurrent disease can be detected by both mammography or women themselves (self-detection). The optimal policies were determined for three risk categories based on differentiation of the primary tumor. Our results suggest a slightly more intensive follow-up for patients with a high risk and poorly differentiated tumor, and a less intensive schedule for the other risk groups.
KW - Partially observable markov decision process
KW - Breast cancer
KW - Optimal policies
KW - Stratified follow-up
U2 - 10.1007/978-3-319-47766-4_7
DO - 10.1007/978-3-319-47766-4_7
M3 - Chapter
SN - 978-3-319-47764-0
T3 - International Series in Operations Research & Management Science
SP - 223
EP - 244
BT - Markov Decision Processes in Practice
A2 - Boucherie, Richard J.
A2 - van Dijk, Nico M.
PB - Springer
CY - Cham
ER -