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Keywords:

  • adaptive treatment strategies;
  • dynamic treatment regimes;
  • personalized medicine;
  • Q-learning;
  • sequential randomization;
  • pharmacoepidemiology

ABSTRACT

Much of current pharmacological practice focuses on identifying the single ‘best’ treatment (or course of treatments) for a particular disease. Recently, however, focus has begun to shift towards a more patient-centric rather than disease-centric approach, where personal characteristics are used to identify the optimal treatment for an individual. Adaptive treatment strategies (also known as dynamic treatment regimes) are part of a rapidly expanding area of research whereby such personalized treatments can be identified. These methods can lead to improved results over standard ‘one size fits all’ approaches, as well as provide a route to formalizing a common practice of using ad hoc approaches when deciding or updating management plans. Here, we provide an introduction to adaptive treatment strategies, explaining their background, their purpose, and how they can be employed in practice. Copyright © 2014 John Wiley & Sons, Ltd.