A dynamic treatment rule (DTR) is a treatment rule which assigns treatments to individuals based on (a subset of) their measured covariates. An optimal DTR is the DTR which maximizes the population mean outcome. Previous works in this area have assumed that treatment is an unlimited resource so that the entire population can be treated if this strategy maximizes the population mean outcome. We consider optimal DTRs in settings where the treatment resource is limited so that there is a maximum proportion of the population which can be treated. We give a general closed-form expression for an optimal stochastic DTR in this resource-limited setting, and a closed-form expression for the optimal deterministic DTR under an additional assumption. We also present an estimator of the mean outcome under the optimal stochastic DTR in a large semiparametric model that at most places restrictions on the probability of treatment assignment given covariates. We give conditions under which our estimator is efficient among all regular and asymptotically linear estimators. All of our results are supported by simulations.
Luedtke, Alexander R. and van der Laan, Mark J., "Optimal Dynamic Treatments in Resource-Limited Settings" (January 2015). U.C. Berkeley Division of Biostatistics Working Paper Series. Working Paper 333.