RESUMO
Innovative data sources and methods for public health surveillance (PHS) have evolved rapidly over the past 10 years, suggesting the need for a closer look at the scientific maturity, feasibility, and utility of use in real-world situations. This article provides an overview of recent innovations in PHS, including data from social media, internet search engines, the Internet of Things (IoT), wastewater surveillance, participatory surveillance, artificial intelligence (AI), and nowcasting. Examples identified suggest that novel data sources and analytic methods have the potential to strengthen PHS by improving disease estimates, promoting early warning for disease outbreaks, and generating additional and/or more timely information for public health action. For example, wastewater surveillance has re-emerged as a practical tool for early detection of the coronavirus disease 2019 (COVID-19) and other pathogens, and AI is increasingly used to process large amounts of digital data. Challenges to implementing novel methods include lack of scientific maturity, limited examples of implementation in real-world public health settings, privacy and security risks, and health equity implications. Improving data governance, developing clear policies for the use of AI technologies, and public health workforce development are important next steps towards advancing the use of innovation in PHS.
RESUMO
The "winner's curse" is a subtle and difficult problem in interpretation of genetic association, in which association estimates from large-scale gene detection studies are larger in magnitude than those from subsequent replication studies. This is practically important because use of a biased estimate from the original study will yield an underestimate of sample size requirements for replication, leaving the investigators with an underpowered study. Motivated by investigation of the genetics of type 1 diabetes complications in a longitudinal cohort of participants in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Genetics Study, we apply a bootstrap resampling method in analysis of time to nephropathy under a Cox proportional hazards model, examining 1,213 single-nucleotide polymorphisms (SNPs) in 201 candidate genes custom genotyped in 1,361 white probands. Among 15 top-ranked SNPs, bias reduction in log hazard ratio estimates ranges from 43.1% to 80.5%. In simulation studies based on the observed DCCT/EDIC genotype data, genome-wide bootstrap estimates for false-positive SNPs and for true-positive SNPs with low-to-moderate power are closer to the true values than uncorrected naïve estimates, but tend to overcorrect SNPs with high power. This bias-reduction technique is generally applicable for complex trait studies including quantitative, binary, and time-to-event traits.
Assuntos
Estudo de Associação Genômica Ampla/métodos , Viés , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/terapia , Reações Falso-Positivas , Feminino , Genótipo , Humanos , Nefropatias/complicações , Nefropatias/genética , Nefropatias/patologia , Masculino , Modelos Genéticos , Fenótipo , Polimorfismo de Nucleotídeo Único/genética , Modelos de Riscos Proporcionais , Risco , Tamanho da Amostra , Fatores de TempoRESUMO
Next generation sequencing has dramatically increased our ability to localize disease-causing variants by providing base-pair level information at costs increasingly feasible for the large sample sizes required to detect complex-trait associations. Yet, identification of causal variants within an established region of association remains a challenge. Counter-intuitively, certain factors that increase power to detect an associated region can decrease power to localize the causal variant. First, combining GWAS with imputation or low coverage sequencing to achieve the large sample sizes required for high power can have the unintended effect of producing differential genotyping error among SNPs. This tends to bias the relative evidence for association toward better genotyped SNPs. Second, re-use of GWAS data for fine-mapping exploits previous findings to ensure genome-wide significance in GWAS-associated regions. However, using GWAS findings to inform fine-mapping analysis can bias evidence away from the causal SNP toward the tag SNP and SNPs in high LD with the tag. Together these factors can reduce power to localize the causal SNP by more than half. Other strategies commonly employed to increase power to detect association, namely increasing sample size and using higher density genotyping arrays, can, in certain common scenarios, actually exacerbate these effects and further decrease power to localize causal variants. We develop a re-ranking procedure that accounts for these adverse effects and substantially improves the accuracy of causal SNP identification, often doubling the probability that the causal SNP is top-ranked. Application to the NCI BPC3 aggressive prostate cancer GWAS with imputation meta-analysis identified a new top SNP at 2 of 3 associated loci and several additional possible causal SNPs at these loci that may have otherwise been overlooked. This method is simple to implement using R scripts provided on the author's website.
Assuntos
Estudo de Associação Genômica Ampla/métodos , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Modelos Teóricos , Polimorfismo de Nucleotídeo Único/genética , Neoplasias da Mama/genética , Feminino , Genótipo , Humanos , Masculino , Neoplasias da Próstata/genética , Tamanho da AmostraRESUMO
We summarize the contributions of Group 9 of Genetic Analysis Workshop 17. This group addressed the problems of linkage disequilibrium and other longer range forms of allelic association when evaluating the effects of genotypes on phenotypes. Issues raised by long-range associations, whether a result of selection, stratification, possible technical errors, or chance, were less expected but proved to be important. Most contributors focused on regression methods of various types to illustrate problematic issues or to develop adaptations for dealing with high-density genotype assays. Study design was also considered, as was graphical modeling. Although no method emerged as uniformly successful, most succeeded in reducing false-positive results either by considering clusters of loci within genes or by applying smoothing metrics that required results from adjacent loci to be similar. Two unexpected results that questioned our assumptions of what is required to model linkage disequilibrium were observed. The first was that correlations between loci separated by large genetic distances can greatly inflate single-locus test statistics, and, whether the result of selection, stratification, possible technical errors, or chance, these correlations seem overabundant. The second unexpected result was that applying principal components analysis to genome-wide genotype data can apparently control not only for population structure but also for linkage disequilibrium.
Assuntos
Desequilíbrio de Ligação , Modelos Estatísticos , Epidemiologia Molecular/métodos , Gráficos por Computador , Interpretação Estatística de Dados , Variação Estrutural do Genoma , Projeto Genoma Humano , Humanos , Modelos Genéticos , Polimorfismo de Nucleotídeo Único , Análise de Componente Principal , Análise de RegressãoRESUMO
The phenomenon known as the winner's curse is a form of selection bias that affects estimates of genetic association. In genome-wide association studies (GWAS) the bias is exacerbated by the use of stringent selection thresholds and ranking over hundreds of thousands of single nucleotide polymorphisms (SNPs). We develop an improved multi-locus bootstrap point estimate and confidence interval, which accounts for both ranking- and threshold-selection bias in the presence of genome-wide SNP linkage disequilibrium structure. The bootstrap method easily adapts to various study designs and alternative test statistics as well as complex SNP selection criteria. The latter is demonstrated by our application to the Wellcome Trust Case Control Consortium findings, in which the selection criterion was the minimum of the p-values for the additive and genotypic genetic effect models. In contrast, existing likelihood-based bias-reduced estimators account for the selection criterion applied to an SNP as if it were the only one tested, and so are more simple computationally, but do not address ranking across SNPs. Our simulation studies show that the bootstrap bias-reduced estimates are usually closer to the true genetic effect than the likelihood estimates and are less variable with a narrower confidence interval. Replication study sample size requirements computed from the bootstrap bias-reduced estimates are adequate 75-90 per cent of the time compared to 53-60 per cent of the time for the likelihood method. The bootstrap methods are implemented in a user-friendly package able to provide point and interval estimation for both binary and quantitative phenotypes in large-scale GWAS.
Assuntos
Estudo de Associação Genômica Ampla/normas , Desequilíbrio de Ligação/genética , Polimorfismo de Nucleotídeo Único/genética , Estudos de Casos e Controles , Simulação por Computador , Intervalos de Confiança , Estudo de Associação Genômica Ampla/métodos , Humanos , Funções Verossimilhança , Modelos Genéticos , Viés de SeleçãoRESUMO
The detrimental effects of the winner's curse, including overestimation of the genetic effects of associated variants and underestimation of sufficient sample sizes for replication studies are well-recognized in genome-wide association studies (GWAS). These effects can be expected to worsen as the field moves from GWAS into whole genome sequencing. To date, few studies have reported statistical adjustments to the naive estimates, due to the lack of suitable statistical methods and computational tools. We have developed an efficient genome-wide non-parametric method that explicitly accounts for the threshold, ranking, and allele frequency effects in whole genome scans. Here, we implement the method to provide bias-reduced estimates via bootstrap re-sampling (BR-squared) for association studies of both disease status and quantitative traits, and we report the results of applying BR-squared to GWAS of psoriasis and HbA1c. We observed over 50% reduction in the genetic effect size estimation for many associated SNPs. This translates into a greater than fourfold increase in sample size requirements for successful replication studies, which in part explains some of the apparent failures in replicating the original signals. Our analysis suggests that adjusting for the winner's curse is critical for interpreting findings from whole genome scans and planning replication and meta-GWAS studies, as well as in attempts to translate findings into the clinical setting.
Assuntos
Estudo de Associação Genômica Ampla/estatística & dados numéricos , Estatísticas não Paramétricas , Frequência do Gene , Predisposição Genética para Doença , Hemoglobinas Glicadas/genética , Humanos , Polimorfismo de Nucleotídeo Único , Psoríase/genética , Característica Quantitativa Herdável , Tamanho da AmostraRESUMO
Genome-wide association studies (GWAS) test for disease-trait associations and estimate effect sizes at tag single-nucleotide polymorphisms (SNPs), which imperfectly capture variation at causal SNPs. Sequencing studies can examine potential causal SNPs directly; however, sequencing the whole genome or exome can be prohibitively expensive. Costs can be limited by using a GWAS to detect the associated region(s) at tag SNPs followed by targeted sequencing to identify and estimate the effect size of the causal variant. Genetic effect estimates obtained from association studies can be inflated because of a form of selection bias known as the winner's curse. Conversely, estimates at tag SNPs can be attenuated compared to the causal SNP because of incomplete linkage disequilibrium. These two effects oppose each other. Analysis of rare SNPs further complicates our understanding of the winner's curse because rare SNPs are difficult to tag and analysis can involve collapsing over multiple rare variants. In two-stage analysis of Genetic Analysis Workshop 17 simulated data sets, we find that selection at the tag SNP produces upward bias in the estimate of effect at the causal SNP, even when the tag and causal SNPs are not well correlated. The bias similarly carries through to effect estimates for rare variant summary measures. Replication studies designed with sample sizes computed using biased estimates will be under-powered to detect a disease-causing variant. Accounting for bias in the original study is critical to avoid discarding disease-associated SNPs at follow up.