Technical Background for "A Precision Medicine Approach to Develop and Internally Validate Optimal Exercise and Weight Loss Treatments for Overweight and Obese Adults with Knee Osteoarthritis"

Xiaotong Jiang; Amanda E. Nelson; Rebecca J. Cleveland; Daniel P. Beavers; Todd A. Schwartz; Liubov Arbeeva; Carolina Alvarez; Leigh F. Callahan; Stephen Messier; Richard Loeser; Michael R. Kosorok

arXiv · 2001.09930

Technical Background for "A Precision Medicine Approach to Develop and Internally Validate Optimal Exercise and Weight Loss Treatments for Overweight and Obese Adults with Knee Osteoarthritis"

Xiaotong Jiang·Amanda E. Nelson·Rebecca J. Cleveland·Daniel P. Beavers·Todd A. Schwartz·Liubov Arbeeva·Carolina Alvarez·Leigh F. Callahan·Stephen Messier·Richard Loeser·Michael R. Kosorok

View original source ↗Read source document ↗Export metadata ↓

Abstract

We provide additional statistical background for the methodology developed in the clinical analysis of knee osteoarthritis in "A Precision Medicine Approach to Develop and Internally Validate Optimal Exercise and Weight Loss Treatments for Overweight and Obese Adults with Knee Osteoarthritis" (Jiang et al. 2020). Jiang et al. 2020 proposed a pipeline to learn optimal treatment rules with precision medicine models and compared them with zero-order models with a Z-test. The model performance was based on value functions, a scalar that predicts the future reward of each decision rule. The jackknife (i.e., leave-one-out cross validation) method was applied to estimate the value function and its variance of several outcomes in IDEA. IDEA is a randomized clinical trial studying three interventions (exercise (E), dietary weight loss (D), and D+E) on overweight and obese participants with knee osteoarthritis. In this report, we expand the discussion and justification with additional statistical background. We elaborate more on the background of precision medicine, the derivation of the jackknife estimator of value function and its estimated variance, the consistency property of jackknife estimator, as well as additional simulation results that reflect more of the performance of jackknife estimators. We recommend reading Jiang et al. 2020 for clinical application and interpretation of the optimal ITR of knee osteoarthritis as well as the overall understanding of the pipeline and recommend using this article to understand the underlying statistical derivation and methodology.

Explore related subjects

stat.ML cs.LG stat.AP

Keep this discovery

BibTeX RIS

Xiaotong Jiang, Amanda E. Nelson, Rebecca J. Cleveland, Daniel P. Beavers, Todd A. Schwartz, Liubov Arbeeva, Carolina Alvarez, Leigh F. Callahan, Stephen Messier, Richard Loeser, Michael R. Kosorok. 2020-01-27. Technical Background for "A Precision Medicine Approach to Develop and Internally Validate Optimal Exercise and Weight Loss Treatments for Overweight and Obese Adults with Knee Osteoarthritis". https://arxiv.org/abs/2001.09930

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

arXiv2026

A Hilbert-Valued Functional Decomposition Framework for Explaining Time-Dependent Outputs

Feature-based explanations quantify features' influence on model predictions, but are primarily designed for scalar outputs. In many applications, however, outputs are functional or multivariate, such as time-dependent trajectories in demand forecasting. Consequently, existing approaches typically explain each output location independently, ignoring dependencies across the output components. We address this limitation by developing a unified framework for feature-based explanations of time-dependent outputs. Specifically, we generalize functional decomposition to Hilbert-valued prediction functions and extend an existing feature-based explanation framework to this setting. Our framework introduces kernel-based output representations that enable time-dependency-aware explanations at multiple levels of temporal granularity, including time-specific, time-resolved, and time-aggregated, while providing a unified view in which existing methods arise as special cases. We validate our framework on synthetic and real-world data, including intraday financial market volatility prediction and energy demand forecasting.

stat.ML↗

arXiv2026

Risk-Averse Decision Making with Multi-Level Reliability Guarantees

Many applications in engineering, including wireless broadcasting, require designs that provide performance certificates at different target outage levels. This paper studies the problem of maximizing the weighted average of such certificates in the presence of uncertainty about the true system state. The problem is shown to be equivalent to an optimization over nested prediction sets, connecting to the literature on conformal prediction and extending prior art on single-level risk-averse decision making. Furthermore, we derive a dual formulation that decouples optimization across input values. Numerical experiments on a diversity-based wireless transmission system illustrate the cost of enforcing multi-level certificates with a single shared policy and trace the Pareto trade-off between multiple reliability levels.

stat.ML↗

arXiv2026

A distribution-free certification framework for trustworthy crash-severity prediction

Crash-severity models inform screening, dispatch and site prioritization, yet are deployed without a finite-sample statement of what one prediction means. Off-the-shelf guarantees fail here, because the features that make crash severity distinctive defeat them: the KABCO outcome is ordinal, the recorded label is a field assessment agreeing with medical severity about half the time, erring in a structured way, and deployment crosses jurisdictions and years calibration never saw. We develop a certification layer that wraps any severity model unmodified, with distribution-free guarantees using this structure: contiguous ordinal sets that read as "B or worse"; per-class validity for any pre-declared partition, with an oracle efficiency characterization; transfer of coverage to unobserved true severity through a declared reporting band, with a worst-case sharpness result; a one-sided certificate under deployment shift; and severity-weighted risk control. The guarantees compose with an attributable slack budget. The same analysis bounds what certification can achieve. A certified set's informativeness is governed by a functional of the true law that no base model can evade and that cannot be lower-bounded distribution-free; given a declared misreporting channel identified from record-linkage data, a nonvacuous lower bound on that floor becomes computable. On 5.2 million Texas records across seven base models spanning four decades, the layer attaches identical validity and certifies, on the vulnerable road users, a model-independent floor on set width that no base model beats, separating it from a remainder that stays bounded but distribution-free unidentifiable. The framework is released as an open-source package with theorem-level tests.

stat.ML↗