Abstract:The goal of precision medicine is to provide individualized treatment at each stage of chronic diseases, a concept formalized by Dynamic Treatment Regimes (DTR). These regimes adapt treatment strategies based on decision rules learned from clinical data to enhance therapeutic effectiveness. Reinforcement Learning (RL) algorithms allow to determine these decision rules conditioned by individual patient data and their medical history. The integration of medical expertise into these models makes possible to increase confidence in treatment recommendations and facilitate the adoption of this approach by healthcare professionals and patients. In this work, we examine the mathematical foundations of RL, contextualize its application in the field of DTR, and present an overview of methods to improve its effectiveness by integrating medical expertise.
Abstract:This chapter presents the main lines of agent based modeling in the field of medical research. The general diagram consists of a cohort of patients (virtual or real) whose evolution is observed by means of so-called evolution models. Scenarios can then be explored by varying the parameters of the different models. This chapter presents techniques for virtual patient generation and examples of execution models. The advantages and disadvantages of these models are discussed as well as the pitfalls to be avoided. Finally, an application to the medico-economic study of the impact of the penetration rate of generic versions of treatments on the costs associated with HIV treatment is presented.