141st APHA Annual Meeting

In This section

281876
Analysis of personalized treatment options from a large clinical trial

Monday, November 4, 2013

Georgiy Bobashev, Ph.D. , RTI International, Durham, NC
Barry Eggleston , RTI International
Nikhil Garge , RTI International
The goal of personalized medicine is to identify treatment with the highest expected success given individual factors. For many diseases that involve individual behavior, such as substance use, finding a small set of strong predictors, might not be feasible due to a large number of factors influencing the outcome. Recently we have developed methodology that considers an ensemble of models and allow one to explore “what if” scenarios. Thus, for an individual with a specific combination of factors our approach provides smooth and stable prediction of potential treatment outcomes under several alternative treatments. We have applied our and other competing methods to identify best personalized treatments of alcoholism to a dataset from the largest clinical trial of several alcohol treatment approaches called COMBINE. We have identified best individual treatments and assessed the effectiveness of the personalized treatment when applied to each patient. We have also assessed the consequences of applying the least effective treatment. We show that for some patients the potential difference in the outcomes between the most effective and the least effective treatment might not have a significant difference, while others could substantially benefit from personalized best choice of treatment.

Learning Areas:
Basic medical science applied in public health
Biostatistics, economics
Epidemiology

Learning Objectives:
Demonstrate how novel statistical predictive methods can help identify patients who could benefit from personalized treatment Discuss applicability of personalized treatment to patient population

Keywords: Alcoholism, Treatment Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a principal investigator of several NIH-funded grants focusing on the epidemiology and treatment of drug abuse. As a biostatistician I have also been a co-investigator on numerous federal grants and contracts on prevention of HIV and cancer. My research focus is predicting health outcomes on both: personal and population levels.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.