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A control systems engineering approach for adaptive behavioral interventions: illustration with a fibromyalgia intervention

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The term adaptive intervention has been used in behavioral medicine to describe operationalized and individually tailored strategies for prevention and treatment of chronic, relapsing disorders. Control systems engineering offers an

The term adaptive intervention has been used in behavioral medicine to describe operationalized and individually tailored strategies for prevention and treatment of chronic, relapsing disorders. Control systems engineering offers an attractive means for designing and implementing adaptive behavioral interventions that feature intensive measurement and frequent decision-making over time. This is illustrated in this paper for the case of a low-dose naltrexone treatment intervention for fibromyalgia. System identification methods from engineering are used to estimate dynamical models from daily diary reports completed by participants. These dynamical models then form part of a model predictive control algorithm which systematically decides on treatment dosages based on measurements obtained under real-life conditions involving noise, disturbances, and uncertainty. The effectiveness and implications of this approach for behavioral interventions (in general) and pain treatment (in particular) are demonstrated using informative simulations.

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  • 2014-09-01

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Optimized treatment of fibromyalgia using system identification and hybrid model predictive control

Description

The term adaptive intervention is used in behavioral health to describe individually tailored strategies for preventing and treating chronic, relapsing disorders. This paper describes a system identification approach for developing

The term adaptive intervention is used in behavioral health to describe individually tailored strategies for preventing and treating chronic, relapsing disorders. This paper describes a system identification approach for developing dynamical models from clinical data, and subsequently, a hybrid model predictive control scheme for assigning dosages of naltrexone as treatment for fibromyalgia, a chronic pain condition. A simulation study that includes conditions of significant plant-model mismatch demonstrates the benefits of hybrid predictive control as a decision framework for optimized adaptive interventions. This work provides insights on the design of novel personalized interventions for chronic pain and related conditions in behavioral health.

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Date Created
  • 2014-12-01