Kenn Michael, Karch Rudolf, Cacsire Castillo-Tong Dan, Singer Christian F, Koelbl Heinz, Schreiner Wolfgang
Section of Biosimulation and Bioinformatics, Center for Medical Statistics, Informatics and Intelligent Systems (CeMSIIS), Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria.
Translational Gynecology Group, Department of Obstetrics and Gynecology Comprehensive Cancer Center, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
J Pers Med. 2022 Apr 2;12(4):570. doi: 10.3390/jpm12040570.
Estrogen and progesterone receptors being present or not represents one of the most important biomarkers for therapy selection in breast cancer patients. Conventional measurement by immunohistochemistry (IHC) involves errors, and numerous attempts have been made to increase precision by additional information from gene expression. This raises the question of how to fuse information, in particular, if there is disagreement. It is the primary domain of Dempster-Shafer decision theory (DST) to deal with contradicting evidence on the same item (here: receptor status), obtained through different techniques. DST is widely used in technical settings, such as self-driving cars and aviation, and is also promising to deliver significant advantages in medicine. Using data from breast cancer patients already presented in previous work, we focus on comparing DST with classical statistics in this work, to pave the way for its application in medicine. First, we explain how DST not only considers probabilities (a single number per sample), but also incorporates uncertainty in a concept of 'evidence' (two numbers per sample). This allows for very powerful displays of patient data in so-called ternary plots, a novel and crucial advantage for medical interpretation. Results are obtained according to conventional statistics (ODDS) and, in parallel, according to DST. Agreement and differences are evaluated, and the particular merits of DST discussed. The presented application demonstrates how decision theory introduces new levels of confidence in diagnoses derived from medical data.
雌激素和孕激素受体的有无是乳腺癌患者治疗方案选择中最重要的生物标志物之一。传统的免疫组织化学(IHC)测量存在误差,人们已进行了大量尝试,通过基因表达的额外信息来提高准确性。这就引发了如何融合信息的问题,尤其是在存在分歧的情况下。处理通过不同技术获得的关于同一项目(此处为受体状态)的相互矛盾证据,是Dempster-Shafer决策理论(DST)的主要领域。DST在自动驾驶汽车和航空等技术领域被广泛应用,在医学领域也有望带来显著优势。利用先前工作中已呈现的乳腺癌患者数据,我们在本研究中专注于将DST与经典统计学进行比较,为其在医学中的应用铺平道路。首先,我们解释DST如何不仅考虑概率(每个样本一个数字),还在“证据”概念中纳入不确定性(每个样本两个数字)。这使得在所谓的三元图中能够非常有效地展示患者数据,这是医学解读的一个新颖且关键的优势。结果根据传统统计学(优势比)得出,同时也根据DST得出。评估一致性和差异,并讨论DST的特殊优点。所展示的应用表明决策理论如何为源自医学数据的诊断引入新的置信水平。
Sci Rep. 2021-2-19
J Pers Med. 2023-1-5
Breast Cancer Res Treat. 2018-8-16
IEEE Trans Cybern. 2022-5
Environ Monit Assess. 2012-9-2
J Pers Med. 2023-1-5
Sci Rep. 2021-2-19
Biomed Res Int. 2020
Breast Cancer Res Treat. 2018-8-16
NPJ Breast Cancer. 2016-6-8
Lancet. 2016-11-17