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Advancing Data-Driven Healthcare Models with Optimization-Based Calibration Methods

Eskandari, Hanie (2023) Advancing Data-Driven Healthcare Models with Optimization-Based Calibration Methods. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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A number of health studies consider Markov models of individual-level disease progression. Typically these studies use simulation-based methods (SBMs) to calibrate the parameters of the models so that model outputs agree with target data related to the disease/condition under consideration. SBMs, however, require a large amount of computation time, ultimately limiting the complexity of models that these studies can actually calibrate
in practice. The black-box nature of these methods also has left open a number of fundamental questions (e.g., understanding conditions under which the parameters of Markov models of disease progression are identifiable). This thesis develops new optimization-based calibration methods that require less computation time than SBMs, explores fundamental questions left open by SBMs, and constructs Markov models for Opioid Use Disorder (OUD) progression and Total Joint Replacement (TJR) recovery.
In Chapter 2 of this thesis, we consider using disease prevalence target data to calibrate a class of discrete-time Markov chain (DTMC) models that have covariate-dependent transition probabilities. We formulate the calibration problem as a (deterministic) non-convex optimization problem and consider solving it with first order methods that just require relatively inexpensive matrix-vector multiplications (instead of simulations). We investigate the
performance of our methods through computational experiments and apply them in a case study on Opioid Use Disorder.
Chapter 3 of this thesis considers the problem of identifying the transition probabilities
of time-homogeneous DTMC models of natural history of disease from target mortality data.
We establish mathematical conditions under which the transition probabilities are identifiable, and we present a polynomial-time algorithm for computing the values of the transition probabilities when they are identifiable. Our approach is premised on an interesting connection to the theory of homogeneous symmetric polynomials.
In Chapter 4, we propose a Markov Decision Process (MDP) model that concurrently uses multiple patient-reported and performance-based measurements as variables that define
the state of the patients to dynamically assess the recovery progress of TJR patients. The model can be used as a tool to devise personalized post-discharge intervention plans for TJR patients.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Eskandari, Haniehae23@pitt.eduhae230000-0002-8710-0631
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Thesis AdvisorLamperski, Jourdain B.lamperski@pitt.edulamperski
Committee MemberMaillart, Lisa M.maillart@pitt.edumaillart
Committee MemberRoberts, Mark S.mroberts@pitt.edumroberts
Committee MemberLee, Hyo
Date: 14 September 2023
Date Type: Publication
Defense Date: 3 July 2023
Approval Date: 14 September 2023
Submission Date: 11 July 2023
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 141
Institution: University of Pittsburgh
Schools and Programs: Swanson School of Engineering > Industrial Engineering
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Markov Models, Calibration, Identifiability, Opioid Use Disorder, Total Joint Replacement
Date Deposited: 14 Sep 2023 13:42
Last Modified: 14 Sep 2023 13:42


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