Markers to guide treatment decisions: Methods and applications in obstetrics and gynecology

This thesis presents a number of studies centered on the evaluation of individual patient characteristics for guiding treatment decisions. The included chapters address both theoretical aspects of methods for marker evaluation (Part 1) as well as applications of these methods in a number of clinical treatment decision dilemmas in obstetrics and gynecology (Part 2).
Choice of treatment is a multidimensional trade-off between positive favorable health effects, negative side effects, along with the burden and costs of treatment to the individual and society, where personal preferences of individual patients can affect the outcome of the trade-off. This complex process can ideally be informed by each person’s unique clinical, genetic, genomic, and environmental markers.
Here, we emphasize the need for developing and disseminating new statistical methods for the identification and evaluation of markers and combination of markers that can guide treatment decisions. We believe that a more widespread application of these methods in medical research will gradually move us towards a more personalized patient care era, wherein treatment is only offered to those who benefit from it, side-effects are reduced, delays in finding the correct treatment and dose are minimized, costs of care are lower, and, overall, health care is more effective and efficient.