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Policy Learning with Observational Data: The Case of Hepatitis C Treatment for HIV/HCV Co-Infected Patients

Raphaël Langevin

arXiv 15 May 2026 · Statistics — Applications

arXiv:2605.16593 · PDF · DOI · OpenAlex · Extracted main text

Abstract

Decision-makers frequently must choose a single action from a finite set of alternatives -- for example, physicians selecting a treatment, investors choosing a portfolio risk level, or judges determining sentences. To improve outcomes, policymakers often issue policy rules or guidelines to inform such choices. In this paper, I show how to generally derive policy rules from observational data in a multi-action framework under relatively weak assumptions about the underlying structure of the heterogeneous sampled population. Conditional average treatment effects (CATEs) are consistently estimated via a weighted K-means algorithm, assuming the outcome model is correctly specified within each homogeneous subgroup. Feasible policy rules are then implemented via a standard decision tree, allowing for both perfect and imperfect adherence to treatment. The methodology is applied to treatment options for Hepatitis C (HCV) among patients co-infected with human immunodeficiency virus (HIV), a setting in which no uniform guideline exists for modern pharmaceutical therapies. The results identify a subgroup of patients with approximately an 80% probability of spontaneous HCV clearance without treatment. Estimation results also show that reallocating treatments among treated individuals could have reduced total treatment costs by CAN$3.6-4.9 million while still increasing aggregate health benefits relative to the status quo. These findings demonstrate that the proposed approach can generate improved, data-driven treatment guidelines for the management of HIV/HCV co-infected patients.

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114
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183
in-text mentions
114
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Most heavily cited references

The works this paper leans on most, across its whole bibliography — not restricted to papers in our corpus. Ranked by composite intensity, which combines how often a work is mentioned, how many sections mention it, and how much of that falls in the main text rather than the appendix.

ReferenceIntensityMentionsSectionsMain text
1Athey, Susan and Wager, Stefan (2021) Policy Learning With Observational Data1.00083100%
2Wilton, James and Wong, Stanley and Yu, Amanda and Ramji, Alnoor and… (2020) Real-world Effectiveness of Sofosbuvir/Velpatasvir for Treatment of Chronic Hepatitis C in British Columbia, Canada: A Populatio…1.00063100%
3Chernozhukov, Victor and Chetverikov, Denis and Demirer, Mert and Du… (2018) Double/debiased machine learning for treatment and structural parameters0.9507486%
4Zhou, Zhengyuan and Athey, Susan and Wager, Stefan (2023) Offline Multi-Action Policy Learning: Generalization and Optimization0.87472100%
5Manski, Charles F (2021) Econometrics for Decision Making: Building Foundations Sketched by Haavelmo and Wald0.81142100%
6Saeed, Sahar and Thomas, Tyler and Dinh, Duy A and Moodie, Erica and… (2024) Frequent Disengagement and Subsequent Mortality Among People With HIV and Hepatitis C in Canada: A Prospective Cohort Study0.81142100%
7Young, Jim and Wang, Shouao and Lanièce Delaunay, Charlotte and Coop… (2023) The rate of hepatitis C reinfection in Canadians coinfected with HIV and its implications for national elimination0.81142100%
8Langevin, Raphaël (2026) Bias-Reduced Estimation of Finite Mixtures: An Application to Latent Group Structures in Panel Data self0.7375260%
9AASLD (2022) Patients With HIV/HCV Coinfection0.73732100%
10Chernozhukov, Victor and Demirer, Mert and Duflo, Esther and Fernand… (2025) Fisher-Schultz Lecture: Generic Machine Learning Inference on Heterogeneous Treatment Effects in Randomized Experiments, With an…0.73732100%

Showing the top 10 of 114 scored citations.