Lee MinJae, Reininger Belinda M, Gabriel Kelley Pettee, Ranjit Nalini, Strong Larkin L
Peter O'Donnell Jr. School of Public Health, Department of Health Data Sciences and Biostatistics, University of Texas Southwestern (UTSW), Dallas, TX, USA.
Simmons Comprehensive Cancer Center, UTSW, Dallas, TX, USA.
J Appl Stat. 2024 Aug 27;52(4):779-813. doi: 10.1080/02664763.2024.2394784. eCollection 2025.
There are many studies aimed at promoting positive lifestyle behaviors to reduce lifetime risk of cancer and related diseases. However, assessing these modifiable behaviors through statistical modeling is challenging because of the multidimensionality of interrelated measurements that may dramatically differ between at-risk individuals. Taking into account this heterogeneity while considering the multidimensionality of behavior changes is fundamental to tailoring interventions to their needs. Biomarkers that identify high-risk individuals may help validate proximal measures, but the number of validated methods that link biomarkers to multiple behavioral measurements by determining their dynamic relations with disease risks is limited to just a few, since it requires an advanced statistical methodology to address challenges in analyzing biomarker data, including left-censoring due to limits of detection. To address these challenges, we propose a method that constructs a quantile-specific weighted index of multiple behavioral measurements. Under the quantile regression framework, the proposed method renders a multidimensional view of risk-specific behavioral patterns by connecting them with biomarker levels to provide better insights into heterogeneous behavioral profiles among at-risk populations. We evaluate performances of the proposed method through simulations, and illustrate its applications to the Tu Salud ¡Sí Cuenta! data by examining behavior changes among Mexican-American adults.
有许多研究旨在促进积极的生活方式行为,以降低患癌症及相关疾病的终生风险。然而,通过统计建模来评估这些可改变的行为具有挑战性,因为相互关联的测量具有多维性,高危个体之间可能存在显著差异。在考虑行为变化的多维性时兼顾这种异质性,对于根据个体需求定制干预措施至关重要。识别高危个体的生物标志物可能有助于验证近端测量方法,但通过确定生物标志物与疾病风险的动态关系将其与多种行为测量联系起来的经过验证的方法数量有限,仅有几种,因为这需要先进的统计方法来应对分析生物标志物数据时的挑战,包括由于检测限导致的左删失。为应对这些挑战,我们提出一种方法,该方法构建多个行为测量的分位数特定加权指数。在分位数回归框架下,所提出的方法通过将风险特定的行为模式与生物标志物水平联系起来,呈现出多维视角,以便更好地洞察高危人群中的异质行为特征。我们通过模拟评估所提出方法的性能,并通过研究墨西哥裔美国成年人的行为变化来说明其在“你的健康很重要!”数据中的应用。