Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, School of Medicine, TU Dresden, Dresden, Germany.
AICURA Medical GmbH, Berlin, Germany.
PLoS One. 2021 Nov 15;16(11):e0256585. doi: 10.1371/journal.pone.0256585. eCollection 2021.
Risk stratification and treatment decisions for leukemia patients are regularly based on clinical markers determined at diagnosis, while measurements on system dynamics are often neglected. However, there is increasing evidence that linking quantitative time-course information to disease outcomes can improve the predictions for patient-specific treatment responses. We designed a synthetic experiment simulating response kinetics of 5,000 patients to compare different computational methods with respect to their ability to accurately predict relapse for chronic and acute myeloid leukemia treatment. Technically, we used clinical reference data to first fit a model and then generate de novo model simulations of individual patients' time courses for which we can systematically tune data quality (i.e. measurement error) and quantity (i.e. number of measurements). Based hereon, we compared the prediction accuracy of three different computational methods, namely mechanistic models, generalized linear models, and deep neural networks that have been fitted to the reference data. Reaching prediction accuracies between 60 and close to 100%, our results indicate that data quality has a higher impact on prediction accuracy than the specific choice of the particular method. We further show that adapted treatment and measurement schemes can considerably improve the prediction accuracy by 10 to 20%. Our proof-of-principle study highlights how computational methods and optimized data acquisition strategies can improve risk assessment and treatment of leukemia patients.
白血病患者的风险分层和治疗决策通常基于诊断时确定的临床标志物,而系统动力学的测量往往被忽视。然而,越来越多的证据表明,将定量时间过程信息与疾病结果联系起来可以提高对患者特定治疗反应的预测。我们设计了一个合成实验,模拟了 5000 名患者的反应动力学,以比较不同的计算方法在准确预测慢性和急性髓性白血病治疗的复发方面的能力。从技术上讲,我们使用临床参考数据首先拟合模型,然后为个体患者的时间过程生成新的模型模拟,我们可以系统地调整数据质量(即测量误差)和数量(即测量次数)。在此基础上,我们比较了三种不同计算方法的预测准确性,即机制模型、广义线性模型和深度神经网络,这些方法都已针对参考数据进行了拟合。我们的结果表明,预测准确性在 60%到接近 100%之间,数据质量对预测准确性的影响比特定方法的选择要高,这表明数据质量对预测准确性的影响比特定方法的选择要高。我们进一步表明,适应性治疗和测量方案可以通过 10%到 20%的幅度显著提高预测准确性。我们的原理验证研究强调了计算方法和优化的数据采集策略如何改善白血病患者的风险评估和治疗。