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The optimal model was selected based on jackknife value function estimates that indicate improvement in the outcomes if future participants follow the estimated decision rule compared to the optimal single, fixed treatment model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Multiple outcome random forest was the optimal model for the WOMAC outcomes. For the other outcomes, list\u2010based models were optimal. For example, the estimated optimal decision rule for weight loss indicated assigning the D + E intervention to participants with baseline weight not exceeding 109.35 kg and waist circumference above 90.25 cm, and assigning D to all other participants except those with a history of a heart attack. If applied to future participants, the optimal rule for weight loss is estimated to increase average weight loss to 11.2 kg at 18 months, contrasted with 9.8 kg if all participants received D + E (<jats:italic>P<\/jats:italic> = 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The precision medicine models supported the overall findings from IDEA that the D + E intervention was optimal for most participants, but there was evidence that a subgroup of participants would likely benefit more from diet alone for 2 outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.24179","type":"journal-article","created":{"date-parts":[[2020,3,7]],"date-time":"2020-03-07T05:02:13Z","timestamp":1583557333000},"page":"693-701","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Precision Medicine Approach to Develop and Internally Validate Optimal Exercise and Weight\u2010Loss Treatments for Overweight and Obese Adults With Knee Osteoarthritis: Data From a Single\u2010Center Randomized Trial"],"prefix":"10.1002","volume":"73","author":[{"given":"Xiaotong","family":"Jiang","sequence":"first","affiliation":[{"name":"University of North Carolina  Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda E.","family":"Nelson","sequence":"additional","affiliation":[{"name":"University of North Carolina  Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca J.","family":"Cleveland","sequence":"additional","affiliation":[{"name":"University of North Carolina  Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel P.","family":"Beavers","sequence":"additional","affiliation":[{"name":"Wake Forest School of Medicine  Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd A.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"University of North Carolina  Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liubov","family":"Arbeeva","sequence":"additional","affiliation":[{"name":"University of North Carolina  Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Alvarez","sequence":"additional","affiliation":[{"name":"University of North Carolina  Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh F.","family":"Callahan","sequence":"additional","affiliation":[{"name":"University of North Carolina  Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Messier","sequence":"additional","affiliation":[{"name":"Wake Forest University  Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2832-6144","authenticated-orcid":false,"given":"Richard","family":"Loeser","sequence":"additional","affiliation":[{"name":"University of North Carolina  Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael\u00a0R.","family":"Kosorok","sequence":"additional","affiliation":[{"name":"University of North Carolina  Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204763"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000479"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.277669"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2013.11.012"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23608"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-018-0130-5"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-statistics-030718-105251"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-10-93"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1010933404324"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btr597"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1201\/9780429246593"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-84858-7"},{"key":"e_1_2_7_14_1","unstructured":"R Foundation.The R project for statistical computing. 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