In this work, we study the optimal design of two-armed clinical trials to maximize the accuracy of parameter estimation in a statistical model, where the interaction between patient covariates and treatment are explicitly incorporated to enable precision medication decisions. Such a modeling extension leads to significant complexities for the produced optimization problems because they include optimization over design and covariates concurrently. We take a min-max optimization model and minimize (over design) the maximum (over population) variance of the estimated interaction effect between treatment and patient covariates. This results in a min-max bilevel mixed integer nonlinear programming problem, which is notably challenging to solve. To address this challenge, we introduce a surrogate optimization model by approximating the objective function, for which we propose two solution approaches. The first approach provides an exact solution based on reformulation and decomposition techniques. In the second approach, we provide a lower bound for the inner optimization problem and solve the outer optimization problem over the lower bound. We test our proposed algorithms with synthetic and real-world data sets and compare them with standard (re)randomization methods. Our numerical analysis suggests that the proposed approaches provide higher-quality solutions in terms of the variance of estimators and probability of correct selection. We also show the value of covariate information in precision medicine clinical trials by comparing our proposed approaches to an alternative optimal design approach that does not consider the interaction terms between covariates and treatment. Summary of Contribution: Precision medicine is the future of healthcare where treatment is prescribed based on each patient information. Designing precision medicine clinical trials, which are the cornerstone of precision medicine, is extremely challenging because sample size is limited and patient information may be multidimensional. This work proposes a novel approach to optimally estimate the treatment effect for each patient type in a two-armed clinical trial by reducing the largest variance of personalized treatment effect. We use several statistical and optimization techniques to produce efficient solution methodologies. Results have the potential to save countless lives by transforming the design and implementation of future clinical trials to ensure the right treatments for the right patients. Doing so will reduce patient risks and reduce costs in the healthcare system.
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Optimal Design of Controlled Experiments for Personalized Decision Making in the Presence of Observational Covariates
Controlled experiments are widely applied in many areas such as clinical trials or user behavior studies in IT companies. Recently, it is popular to study experimental design problems to facilitate personalized decision making. In this paper, we investigate the problem of optimal design of multiple treatment allocation for personalized decision making in the presence of observational covariates associated with experimental units (often, patients or users). We assume that the response of a subject assigned to a treatment follows a linear model which includes the interaction between covariates and treatments to facilitate precision decision making. We define the optimal objective as the maximum variance of estimated personalized treatment effects over different treatments and different covariates values. The optimal design is obtained by minimizing this objective. Under a semi-definite program reformulation of the original optimization problem, we use a YALMIP and MOSEK based optimization solver to provide the optimal design. Numerical studies are provided to assess the quality of the optimal design.
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- Award ID(s):
- 1651912
- PAR ID:
- 10397881
- Date Published:
- Journal Name:
- The New England Journal of Statistics in Data Science
- ISSN:
- 2693-7166
- Page Range / eLocation ID:
- 1 to 8
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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