# Efficient estimation of optimal regimes under a no direct effect assumption

arXiv: https://arxiv.org/abs/1908.10448 · HTML: https://mlsanity.com/paper/1908.10448/

## Key facts

- Cited by 5 papers in the map (data through 14 Oct 2026).
- First posted on arXiv 27 Aug 2019.

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## Abstract (arXiv)

We derive new estimators of an optimal joint testing and treatment regime under the no direct effect (NDE) assumption that a given laboratory, diagnostic, or screening test has no effect on a patient's clinical outcomes except through the effect of the test results on the choice of treatment. We model the optimal joint strategy using an optimal regime structural nested mean model (opt-SNMM). The proposed estimators are more efficient than previous estimators of the parameters of an opt-SNMM because they efficiently leverage the `no direct effect (NDE) of testing' assumption. Our methods will be of importance to decision scientists who either perform cost-benefit analyses or are tasked with the estimation of the `value of information' supplied by an expensive diagnostic test (such as an MRI to screen for lung cancer).