Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China.
Stat Med. 2020 Dec 30;39(30):4605-4620. doi: 10.1002/sim.8743. Epub 2020 Sep 24.
Informative and accurate survival prediction with individualized dynamic risk profiles over time is critical for personalized disease prevention and clinical management. The massive genetic data, such as SNPs from genome-wide association studies (GWAS), together with well-characterized time-to-event phenotypes provide unprecedented opportunities for developing effective survival prediction models. Recent advances in deep learning have made extraordinary achievements in establishing powerful prediction models in the biomedical field. However, the applications of deep learning approaches in survival prediction are limited, especially with utilizing the wealthy GWAS data. Motivated by developing powerful prediction models for the progression of an eye disease, age-related macular degeneration (AMD), we develop and implement a multilayer deep neural network (DNN) survival model to effectively extract features and make accurate and interpretable predictions. Various simulation studies are performed to compare the prediction performance of the DNN survival model with several other machine learning-based survival models. Finally, using the GWAS data from two large-scale randomized clinical trials in AMD with over 7800 observations, we show that the DNN survival model not only outperforms several existing survival prediction models in terms of prediction accuracy (eg, c-index =0.76), but also successfully detects clinically meaningful risk subgroups by effectively learning the complex structures among genetic variants. Moreover, we obtain a subject-specific importance measure for each predictor from the DNN survival model, which provides valuable insights into the personalized early prevention and clinical management for this disease.
随着时间的推移,提供信息丰富且准确的个体化动态风险概况对于个性化疾病预防和临床管理至关重要。大量的遗传数据,如全基因组关联研究(GWAS)中的 SNPs,以及特征良好的生存时间表型,为开发有效的生存预测模型提供了前所未有的机会。深度学习的最新进展在建立强大的生物医学领域预测模型方面取得了非凡的成就。然而,深度学习方法在生存预测中的应用受到限制,特别是在利用丰富的 GWAS 数据方面。受开发一种用于眼部疾病(年龄相关性黄斑变性,AMD)进展的强大预测模型的启发,我们开发并实施了一种多层深度神经网络(DNN)生存模型,以有效提取特征并进行准确和可解释的预测。进行了各种模拟研究,以比较 DNN 生存模型与其他几种基于机器学习的生存模型的预测性能。最后,使用来自 AMD 两项大型随机临床试验的 GWAS 数据(超过 7800 个观测值),我们表明 DNN 生存模型不仅在预测准确性方面(例如,c 指数=0.76)优于几种现有的生存预测模型,而且还通过有效学习遗传变异之间的复杂结构,成功检测到具有临床意义的风险亚组。此外,我们从 DNN 生存模型中获得了每个预测因子的个体特异性重要性度量,这为该疾病的个性化早期预防和临床管理提供了有价值的见解。