Related Experiment Video
Updated: Nov 29, 2025
Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
Treatment selection for life-critical shared decision making under ranges of health-state utility scenarios
Evangelos Triantaphyllou1, Juri Yanase2
1Division of Computer Science & Engin, College of Engineering, Louisiana State University, Baton Rouge, LA 70803, USA; Department of Medicine, Section of Hematology & Med Oncology, School of Medicine, Tulane University, New Orleans, LA 70112, USA.
Background:
Selecting the best treatment for life-critical conditions via a shared decision making approach is a uniquely important challenge. Besides data from the healthcare physicians, other data that need to be considered are the personal values and perceptions of the patient. Usually, these data come in the form of health-state utility values. They are subjective and often times are elicited from the patient under emotional and stressful conditions. This paper examines an approach for selecting the best treatment under a life-critical shared decision making (SDM) framework.
Methods:
Health-state utility values are used in practice to quantify what is known as quality-adjusted life years (QALYs) and quality-adjusted life expectancy (QALE). The QALEs from different treatments are used to select the best treatment. This paper describes methods for determining QALEs under a range of scenarios defined by the way some key assumptions on the health-state utility values are satisfied. Approaches for comparing different treatments are described along with some counter-intuitive results. These approaches are based on some optimization formulations. The proposed approaches are demonstrated in terms of a real example taken from the literature.
Results:
Having results that are robust under a spectrum of different scenarios can provide more confidence that the most suitable treatment has been selected in a given case. On the other hand, having non-robust results can be useful information too as they may provide evidence that a more thorough assessment of the benefits and harms of the treatments may be needed to select a treatment with higher confidence. Finally, this study demonstrates that under certain mathematical conditions among the data it is possible to decide which treatment is better among two treatments without having to use health-state utility values.
Conclusion:
The significance of this study is that it provides valuable and actionable insights for the important question of how health-state utilities can be used in treatment selection.
More Related Videos
Related Concept Videos
01:27Ethical Issues
Ethical Concerns in Healthcare:
01:30Ethical Dilemmas II
01:09Decision Making: P-value Method
First, a specific claim about the population parameter is proposed. The claim is based on the research question and is stated in a simple form. Further, an opposing statement to the claim is also stated. These statements can act as null and alternative hypotheses: a null hypothesis would be a neutral statement while the alternative hypothesis can...
01:26Pharmacokinetic Models: Comparison and Selection Criterion
Physiological models take a detailed approach by considering specific molecular processes. They can predict drug distribution, metabolism, and elimination changes, providing a comprehensive understanding of how drugs interact with the body.
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:27Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...