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Robust and adaptive anticoagulant control

Research output: Contribution to journalJournal article

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<mark>Journal publication date</mark>13/01/2020
<mark>Journal</mark>Journal of the Royal Statistical Society: Series C (Applied Statistics)
Publication statusAccepted/In press
Original languageEnglish

Abstract

We consider a control theory approach to adaptive dose allocation of anticoagulants, based on an analysis of records of 152 patients on long-term warfarin treatment. We consider a selection of statistical models for the relationship between dose of drug and subsequent blood clotting speed, measured through the International Normalised Ratio. Our main focus is on subsequent use of the model in guiding choice of the next dose adaptively as patient-specific information accrues. We compare a naive myopic approach with a proportional integral plus method, with parameters estimated by either linear quadratic optimisation or by stochastic resource allocation. We demonstrate advantages of the control approaches in comparison to naive in simulations and through calculation of robust stability margins for the observed data.