Title
Optimal Timing to Initiate Medical Treatment for a Disease Evolving as a Semi-Markov Process.
Abstract
In this paper, we consider the problem of the optimal timing to initiate a medical treatment. In the absence of treatment, we model the disease evolution as a semi-Markov process. The optimal time to initiate the treatment is a stopping time, which maximizes the total expected reward for the patient. We propose a stochastic dynamic programming formulation to find this stopping time. Under some plausible conditions, we show that the maximum total expected reward at the start of a health state will be smaller when the patient is in a more severe state. We then prove that the optimal policy for initializing the treatment is determined by a time threshold for each given health state. That is, in each health state, the treatment should be planned to start, when the patient’s duration time in the health state reaches (or exceeds, in the case of a late observation of the patient’s health status) a certain threshold level. We also present numerical examples to illustrate our model and to provide managerial insights.
Year
DOI
Venue
2017
10.1007/s10957-017-1139-7
J. Optimization Theory and Applications
Keywords
Field
DocType
Healthcare modeling,Semi-Markov process,Optimal policy,90B50
Disease,Mathematical optimization,Markov process,Q-learning,Medical treatment,Initialization,Stochastic programming,Stopping time,Mathematics
Journal
Volume
Issue
ISSN
175
1
0022-3239
Citations 
PageRank 
References 
1
0.36
6
Authors
3
Name
Order
Citations
PageRank
Mabel C. Chou113711.43
Mahmut Parlar228133.65
Yun Zhou341.24