Gao Yan, Cui Yan
Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America.
Center for Integrative and Translational Genomics, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America.
PLOS Digit Health. 2022;1(5). doi: 10.1371/journal.pdig.0000038. Epub 2022 May 26.
Accurate time-to-event (TTE) prediction of clinical outcomes from personal biomedical data is essential for precision medicine. It has become increasingly common that clinical datasets contain information for multiple related patient outcomes from comorbid diseases or multifaceted endpoints of a single disease. Various TTE models have been developed to handle competing risks that are related to mutually exclusive events. However, clinical outcomes are often non-competing and can occur at the same time or sequentially. Here we develop TTE prediction models with the capacity of incorporating compatible related clinical outcomes. We test our method on real and synthetic data and find that the incorporation of related auxiliary clinical outcomes can: 1) significantly improve the TTE prediction performance of conventional Cox model while maintaining its interpretability; 2) further improve the performance of the state-of-the-art deep learning based models. While the auxiliary outcomes are utilized for model training, the model deployment is not limited by the availability of the auxiliary outcome data because the auxiliary outcome information is not required for the prediction of the primary outcome once the model is trained.
从个人生物医学数据中准确预测临床结局的事件发生时间(TTE)对于精准医学至关重要。临床数据集包含来自合并症或单一疾病多方面终点的多个相关患者结局的信息,这种情况已越来越普遍。已经开发了各种TTE模型来处理与互斥事件相关的竞争风险。然而,临床结局通常并非相互竞争的,可能同时或相继发生。在此,我们开发了具有纳入兼容相关临床结局能力的TTE预测模型。我们在真实数据和合成数据上测试了我们的方法,发现纳入相关辅助临床结局可以:1)在保持传统Cox模型可解释性的同时,显著提高其TTE预测性能;2)进一步提高基于深度学习的最先进模型的性能。虽然辅助结局用于模型训练,但模型部署不受辅助结局数据可用性的限制,因为一旦模型训练完成,预测主要结局时不需要辅助结局信息。