Optimal cholesterol treatment plans and genetic testing strategies for cardiovascular diseases

Wesley J. Marrero (), Mariel S. Lavieri and Jeremy B. Sussman
Additional contact information
Wesley J. Marrero: University of Michigan
Mariel S. Lavieri: University of Michigan
Jeremy B. Sussman: University of Michigan

Health Care Management Science, 2021, vol. 24, issue 1, No 1, 25 pages

Abstract: Abstract Atherosclerotic cardiovascular disease (ASCVD) is among the leading causes of death in the US. Although research has shown that ASCVD has genetic elements, the understanding of how genetic testing influences its prevention and treatment has been limited. To this end, we model the health trajectory of patients stochastically and determine treatment and testing decisions simultaneously. Since the cholesterol level of patients is one controllable risk factor for ASCVD events, we model cholesterol treatment plans as Markov decision processes. We determine whether and when patients should receive a genetic test using value of information analysis. By simulating the health trajectory of over 64 million adult patients, we find that 6.73 million patients undergo genetic testing. The optimal treatment plans informed with clinical and genetic information save 5,487 more quality-adjusted life-years while costing $1.18 billion less than the optimal treatment plans informed with clinical information only. As precision medicine becomes increasingly important, understanding the impact of genetic information becomes essential.

Keywords: Operations research; Value of information; Markov decision process; Stochastic simulation; Cardiovascular disease; Genetic testing (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
http://link.springer.com/10.1007/s10729-020-09537-x Abstract (text/html)
Access to the full text of the articles in this series is restricted.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:kap:hcarem:v:24:y:2021:i:1:d:10.1007_s10729-020-09537-x

Ordering information: This journal article can be ordered from
http://www.springer.com/journal/10729

DOI: 10.1007/s10729-020-09537-x

Access Statistics for this article

Health Care Management Science is currently edited by Yasar Ozcan

More articles in Health Care Management Science from Springer
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().