论文标题
加权COX回归用于预测异质患者亚组的预测
Weighted Cox regression for the prediction of heterogeneous patient subgroups
论文作者
论文摘要
临床医学中的一个重要任务是基于高维分子测量(例如基因表达数据)为患者特定亚组的风险预测模型的构建。建模高维数据的主要目标是良好的预测性能和功能选择,以找到与临床结果(例如发生时间端点的临床结果)真正相关的预测因子的子集。在临床实践中,这项任务具有挑战性,因为患者队列通常很小,并且在预测因子和结果之间的关系方面可能是异质的。当有几个患有相同或相似疾病的患者的数据的数据时,很容易将它们结合起来增加样本量,例如在多中心研究中。但是,亚组之间的异质性可能导致偏见,亚组特异性效应可能仍未被发现。在这种情况下,我们提出了一个受惩罚的Cox回归模型,其加权版本的Cox部分可能性包括包括所有亚组的患者,但根据其亚组隶属关系分配了个体权重。可能属于感兴趣亚组的患者在亚组特异性模型中获得更高的权重。我们提出的方法是通过模拟和对真正的肺癌队列的应用来评估的。仿真结果表明,我们的模型可以在标准方法上实现改进的预测和可变选择精度。
An important task in clinical medicine is the construction of risk prediction models for specific subgroups of patients based on high-dimensional molecular measurements such as gene expression data. Major objectives in modeling high-dimensional data are good prediction performance and feature selection to find a subset of predictors that are truly associated with a clinical outcome such as a time-to-event endpoint. In clinical practice, this task is challenging since patient cohorts are typically small and can be heterogeneous with regard to their relationship between predictors and outcome. When data of several subgroups of patients with the same or similar disease are available, it is tempting to combine them to increase sample size, such as in multicenter studies. However, heterogeneity between subgroups can lead to biased results and subgroup-specific effects may remain undetected. For this situation, we propose a penalized Cox regression model with a weighted version of the Cox partial likelihood that includes patients of all subgroups but assigns them individual weights based on their subgroup affiliation. Patients who are likely to belong to the subgroup of interest obtain higher weights in the subgroup-specific model. Our proposed approach is evaluated through simulations and application to real lung cancer cohorts. Simulation results demonstrate that our model can achieve improved prediction and variable selection accuracy over standard approaches.