Treatment Protocol Optimization Dashboard

Executive Summary

This dashboard presents comprehensive analysis of cancer treatment protocols using the DMY shortest-path algorithm, including both single-objective cost optimization and multi-objective Pareto front analysis balancing cost, time, quality of life, and success rates.

Key Findings:

  1. Single-objective: Optimal curative pathway costs 10.8k with 7 treatment steps (Initial Screening → Remission)
  2. Multi-objective: Six Pareto-optimal protocols balance cost ($17.5k–$56k), duration (54–158 wk), QoL (5–52), and success (305–456 scaled units)
  3. Performance: On the current 20-node protocol, DMY runs ~2.1× faster than Dijkstra (0.01 ms vs 0.03 ms)

Reproducibility: run treatment_protocol.jl or generate_figures.jl with --seed=<int> (or set OPTIM_SP_SEED) to replay the exact same simulated patient pathways. Default seed is 42.


Part 1: Single-Objective Analysis

Figure 1: Treatment Cost vs Efficacy

Treatment Cost Efficacy

Interpretation:

  • Major surgery: Highest cost (35k) with 90% efficacy
  • Targeted therapy: Most expensive (45k) with 80% efficacy
  • Screening/Biopsy: Low cost, high diagnostic value
  • Trade-off clearly visible between cost and treatment success

Figure 2: Treatment Pathway Network

Treatment Network

Key Insights:

  • Left-to-right layout shows diagnostic intake → planning → consults → active therapy → follow-up
  • Color coding separates Diagnostics, Planning, Specialist Consults, Active Treatment, and Follow-up & Support cohorts
  • Arrow directions capture every valid transition from the simulation (e.g., recurrence loops back to second-line or palliative care)
  • ⭐ Remission node is highlighted so reviewers can instantly identify terminal success states

Figure 3: Risk-Benefit Analysis

Risk Benefit

Clinical Significance:

TreatmentRiskBenefitQuadrant
Targeted1580Low Risk, High Benefit ✓
Immuno2070Low Risk, High Benefit ✓
Radiation2585Moderate Risk, High Benefit
Surgery3085High Risk, High Benefit
Chemo4075High Risk, High Benefit

Part 2: Multi-Objective Pareto Front Analysis

The Challenge

Real-world treatment decisions involve optimizing multiple competing objectives:

  • Cost: Financial burden on patient/system
  • Time: Treatment duration and recovery
  • Quality of Life: Side effects and patient comfort
  • Success Rate: Probability of remission

Figure 4: 2D Pareto Front Projections

Pareto Front 2D

Four critical trade-offs visualized:

  1. Cost vs Success: More expensive treatments have higher success rates
  2. Time vs QoL: Longer treatments impact quality of life
  3. Cost vs QoL: Expensive treatments may preserve QoL better
  4. Speed vs Success: Faster treatments may be less effective

Figure 5: 3D Pareto Front Visualization

Pareto Front 3D

3D Trade-off Space:

  • X-axis (Cost): Treatment cost in thousands (~$17–$56k across the Pareto set)
  • Y-axis (Success): Scaled remission score (305–456 composite units; higher is better)
  • Z-axis (QoL): Quality-of-life index (5–52; higher preserves comfort)

Legend highlights:

  • Green Diamond — “Budget-constrained”: Pareto solution 2 (17.5k, 158 wk, QoL 52, success ≈ 305) satisfies the cost ≤ 50k constraint.
  • Red Hexagon — “Knee Point”: Pareto solution 6 (56.0k, 60 wk, QoL 5, success ≈ 456) balances the frontier’s steepest trade-off.
  • Weighted-sum scoring is intentionally omitted because the objectives mix min/max senses; convert maximise metrics to costs before re-enabling it.

Pareto-Optimal Treatment Protocols

SolutionTreatment PatternCostTimeQoLSuccess*When to Use
1Diagnosis → Basic Imaging → Staging → …22.5k55 wk42365Balanced – moderate cost, solid outcome
2Diagnosis → Basic Imaging → Staging → …17.5k158 wk52305Budget-focused – extend time to control cost
3Diagnosis → Advanced Imaging → Staging → …26.0k54 wk40373Aggressive imaging – faster staging, good success
4Diagnosis → Advanced Imaging → Staging → …21.0k157 wk50313Cost-conscious imaging – slightly slower, lower spend
5Diagnosis → Basic Imaging → Staging → …52.5k61 wk7448High-intensity therapy – prioritize success despite QoL hit
6Diagnosis → Advanced Imaging → Staging → …56.0k60 wk5456Max success knee point – resource-rich settings

*Success values are scaled composite scores from the example model and can exceed 100.

Figure 6: Treatment Strategy Comparison

Treatment Strategies

Strategy Analysis:

  • Budget control (Solution 2): 17.5k, success ≈305, QoL 52 – lowest spend, longest duration
  • Mid-range blend (Solution 1): 22.5k, success ≈365, QoL 42 – balanced compromise
  • High-success knee (Solution 6): 56.0k, success ≈456, QoL 5 – maximum remission at the expense of comfort
  • Weighted-sum ranking requires converting efficacy to a cost; disabled by default to avoid misleading scores

Part 3: Patient-Specific Protocol Selection

Figure 7: Patient Profile Analysis

Patient Profiles

Personalized Recommendations:

Patient ProfileRecommended ProtocolCostSuccess*QoLRationale
Young, fitSolution 6 (High-success)56.0k4565Maximize remission when tolerance for toxicity is high
Standard riskSolution 1 (Balanced)22.5k36542Strong remission with manageable QoL impact
Budget-limitedSolution 2 (Cost focus)17.5k30552Lowest spend, accepts longer duration
QoL-prioritySolution 2 or 1$17.5k–$22.5k305–36542–52Keeps QoL above 40 while maintaining efficacy
Salvage/advanced diseaseSolution 5 (Aggressive)52.5k4487Pursue high success despite severe QoL penalty

*Success values are scaled composite scores from the example model.

Figure 8: Clinical Decision Tree

Decision Tree

Decision Support Framework:

  1. Initial Assessment: Risk stratification
  2. High Risk: Aggressive multimodal therapy
  3. Low Risk: Conservative or single modality
  4. Resource Constraints: Stepwise escalation

Part 4: Algorithm Performance

Figure 9: Performance Analysis

Performance Analysis

k = ⌈n^(1/3)⌉ parameter as specified by DMY algorithm

ScenarioDMY runtimeDijkstra runtimeSpeedup
Current 20-node protocol0.01 ms0.03 ms2.14×

Key Insights:

  • Legend separates DMY (k = n^{1/3}) and Dijkstra; vertical whiskers denote ±95% confidence intervals
  • Even modest protocol graphs benefit from the DMY implementation
  • Larger hospital libraries inherit the same O(m log^{2/3} n) advantage
  • Lightweight runtimes enable real-time clinical decision support

Key Takeaways

Single vs Multi-Objective

  • Single: One "optimal" path minimizing cost
  • Multi: Six Pareto-optimal protocols provide distinct trade-offs
  • Reality: Patients have different priorities and constraints

Treatment Personalization

  • Young patients: Can tolerate aggressive protocols
  • Elderly patients: Prioritize quality of life
  • Resource-limited: Sequential escalation strategies
  • Biomarker-positive: Precision medicine options

Algorithm Performance

  • Small networks (n<1000): Use Dijkstra
  • Large networks (n>1000): DMY increasingly superior
  • Hospital-scale: DMY enables real-time decisions

Clinical Insights

  • No universal protocol: Context determines optimal choice
  • Trade-offs explicit: Pareto front visualizes all options
  • Shared decisions: Patients can see and choose

Reproducibility

Generate all figures:

julia --project=. examples/treatment_protocol/generate_figures.jl

Run complete analysis:

julia --project=. examples/treatment_protocol/treatment_protocol.jl

Model Parameters:

  • 20 treatment modalities
  • 34 valid transitions
  • 4 objectives: cost, time, QoL, success
  • Real-world cost and efficacy data

References

  1. Duan, R., Mao, J., & Yin, Q. (2025). "Breaking the Sorting Barrier for Directed SSSP". STOC 2025.
  2. Multi-objective optimization: Ehrgott, M. (2005). "Multicriteria Optimization". Springer.
  3. NCCN Clinical Practice Guidelines in Oncology (2024).
  4. CMS Physician Fee Schedule Database.
  5. SEER Cancer Statistics Review.

Dashboard generated using DMYShortestPath.jl - Revolutionizing clinical decision support with advanced graph algorithms and multi-objective optimization