Q‐Learning in Dynamic Treatment Regimes With Misclassified Binary Outcome
Bibliographic record
Abstract
The study of precision medicine involves dynamic treatment regimes (DTRs), which are sequences of treatment decision rules recommended based on patient-level information. The primary goal of the DTR study is to identify an optimal DTR, a sequence of treatment decision rules that optimizes the clinical outcome across multiple decision points. Statistical methods have been developed in recent years to estimate an optimal DTR, including Q-learning, a regression-based method in the DTR literature. Although there are many studies concerning Q-learning, little attention has been paid in the presence of noisy data, such as misclassified outcomes. In this article, we investigate the effect of outcome misclassification on identifying optimal DTRs using Q-learning and propose a correction method to accommodate the misclassification effect on DTR. Simulation studies are conducted to demonstrate the satisfactory performance of the proposed method. We illustrate the proposed method using two examples from the National Health and Nutrition Examination Survey Data I Epidemiologic Follow-up Study and the Population Assessment of Tobacco and Health Study.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.046 | 0.105 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.004 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".