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Dynamic prediction: A challenge for biostatisticians, but greatly needed by patients, physicians and the public
Biometrical Journal ( IF 1.7 ) Pub Date : 2019-03-25 , DOI: 10.1002/bimj.201800248
Martin Schumacher 1 , Stefanie Hieke 1, 2 , Gabriele Ihorst 3 , Monika Engelhardt 4
Affiliation  

Prognosis is usually expressed in terms of the probability that a patient will or will not have experienced an event of interest t years after diagnosis of a disease. This quantity, however, is of little informative value for a patient who is still event-free after a number of years. Such a patient would be much more interested in the conditional probability of being event-free in the upcoming t years, given that he/she did not experience the event in the s years after diagnosis, called "conditional survival." It is the simplest form of a dynamic prediction and can be dealt with using straightforward extensions of standard time-to-event analyses in clinical cohort studies. For a healthy individual, a related problem with further complications is the so-called "age-conditional probability of developing cancer" in the next t years. Here, the competing risk of dying from other diseases has to be taken into account. For both situations, the hazard function provides the central dynamic concept, which can be further extended in a natural way to build dynamic prediction models that incorporate both baseline and time-dependent characteristics. Such models are able to exploit the most current information accumulating over time in order to accurately predict the further course or development of a disease. In this article, the biostatistical challenges as well as the relevance and importance of dynamic prediction are illustrated using studies of multiple myeloma, a hematologic malignancy with a formerly rather poor prognosis which has improved over the last few years.

中文翻译:

动态预测:生物统计学家面临的挑战,但患者、医生和公众非常需要

预后通常用患者在疾病诊断 t 年后经历或不经历感兴趣事件的概率来表示。然而,对于多年后仍然无事件的患者来说,这个数量没有什么信息价值。考虑到他/她在诊断后的 s 年内没有经历过事件,称为“有条件生存”,这样的患者会对未来 t 年无事件的条件概率更感兴趣。它是动态预测的最简单形式,可以在临床队列研究中使用标准时间到事件分析的直接扩展来处理。对于一个健康的人来说,一个具有进一步并发症的相关问题是所谓的“患癌症的年龄条件概率” 在接下来的 t 年。在这里,必须考虑因其他疾病而死亡的竞争风险。对于这两种情况,风险函数提供了中心动态概念,可以以自然的方式进一步扩展,以构建包含基线和时间相关特征的动态预测模型。此类模型能够利用随着时间推移积累的最新信息,以准确预测疾病的进一步进程或发展。在本文中,生物统计学的挑战以及动态预测的相关性和重要性通过对多发性骨髓瘤的研究进行说明,多发性骨髓瘤是一种血液系统恶性肿瘤,以前预后较差,但在过去几年中有所改善。对于这两种情况,风险函数提供了中心动态概念,可以以自然的方式进一步扩展,以构建包含基线和时间相关特征的动态预测模型。此类模型能够利用随着时间推移积累的最新信息,以准确预测疾病的进一步进程或发展。在本文中,生物统计学的挑战以及动态预测的相关性和重要性通过对多发性骨髓瘤的研究进行说明,多发性骨髓瘤是一种血液系统恶性肿瘤,以前预后较差,但在过去几年中有所改善。对于这两种情况,风险函数提供了中心动态概念,可以以自然的方式进一步扩展,以构建包含基线和时间相关特征的动态预测模型。此类模型能够利用随着时间推移积累的最新信息,以准确预测疾病的进一步进程或发展。在本文中,生物统计学的挑战以及动态预测的相关性和重要性通过对多发性骨髓瘤的研究进行说明,多发性骨髓瘤是一种血液系统恶性肿瘤,以前预后较差,但在过去几年中有所改善。可以以自然的方式进一步扩展以构建包含基线和时间相关特征的动态预测模型。此类模型能够利用随着时间推移积累的最新信息,以准确预测疾病的进一步进程或发展。在本文中,生物统计学的挑战以及动态预测的相关性和重要性通过对多发性骨髓瘤的研究进行说明,多发性骨髓瘤是一种血液系统恶性肿瘤,以前预后较差,但在过去几年中有所改善。可以以自然的方式进一步扩展以构建包含基线和时间相关特征的动态预测模型。此类模型能够利用随着时间推移积累的最新信息,以准确预测疾病的进一步进程或发展。在本文中,生物统计学的挑战以及动态预测的相关性和重要性通过对多发性骨髓瘤的研究进行说明,多发性骨髓瘤是一种血液系统恶性肿瘤,以前预后较差,但在过去几年中有所改善。
更新日期:2019-03-25
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