A multi-objective constrained partially observable Markov decision process model for breast cancer screening
نویسندگان
چکیده
Breast cancer is a common and deadly disease, but it often curable when diagnosed early. While most countries have large-scale screening programs, there no consensus on single globally accepted guideline for breast screening. The complex nature of the disease; limited availability methods such as mammography, magnetic resonance imaging (MRI), ultrasound; public health policies all factor into development policies. Resource concerns necessitate design which conform to budget, problem can be modelled constrained partially observable Markov decision process (CPOMDP). In this study, we propose multi-objective CPOMDP model allows supplemental accompany mammography. has two objectives: maximize quality-adjusted life years (QALYs) minimize lifetime mortality risk (LBCMR). We identify Pareto frontier optimal solutions average high-risk patients at different budget levels, used by decision-makers set in practice. find that obtained using weighted objective are able generate well-balanced QALYs LBCMR values. contrast, single-objective models generally sacrifice substantial amount terms QALYs/LBCMR minimal gain LBCMR/QALYs. Additionally, our results show that, with baseline cost values screenings well additional disutility they incur, rarely recommended policies, especially budget-constrained setting. A sensitivity analysis reveals thresholds become advantageous prescribe.
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ژورنال
عنوان ژورنال: Operational Research
سال: 2023
ISSN: ['1866-1505', '1109-2858']
DOI: https://doi.org/10.1007/s12351-023-00774-w