Designing Personalized Treatment: An Application to Anticoagulation Therapy

In this study, we develop an analytical framework for personalizing the anticoagulation therapy of patients who are taking warfarin. Consistent with medical practice, our treatment design consists of two stages: (i) the initiation stage, modeled using a partially‐observable Markov decision process, during which the physician learns through systematic belief updates about the unobservable patient sensitivity to warfarin, and (ii) the maintenance stage, modeled using a Markov decision process, during which the physician relies on his formed belief about patient sensitivity to determine the stable, patient‐specific, warfarin dose to prescribe. We develop an expression for belief updates in the POMDP, establish the optimality of the myopic policy for the MDP, and derive conditions for the existence and uniqueness of a myopically optimal dose. We validate our models using a real‐life patient data set gathered at the Hematology Clinic of the Jewish General Hospital in Montreal. The proposed analytical framework and case study enable us to develop useful clinical insights, for example, concerning the length of the initiation period and the importance of correctly assessing patient sensitivity.     

Effect of financial development on economic growth in sub-Saharan Africa

This paper examines the overall economic growth effect when the growth in finance and real sector is disproportionate relying on panel data for 29 sub-Saharan African countries over the period 1980–2014. Results from the system generalized methods of moments (GMM) reveal that, while financial development supports economic growth, the extent to which finance helps growth depends crucially on the simultaneous growth of real and financial sectors. The elasticity of growth to changes in either size of the real or financial sector is higher under balanced sectoral growth. We also show that rapid and unbridled credit growth comes at a huge cost to economic growth with consequences stemming from financing of risky and unsustainable investments coupled with superfluous consumption fueling inflation. However, the pass-through excess finance–economic growth effect via the investment channel is stronger.