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1.
Bioinformatics ; 39(12)2023 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-38060266

RESUMO

SUMMARY: Densely measured SNP data are routinely analyzed but face challenges due to its high dimensionality, especially when gene-environment interactions are incorporated. In recent literature, a functional analysis strategy has been developed, which treats dense SNP measurements as a realization of a genetic function and can 'bypass' the dimensionality challenge. However, there is a lack of portable and friendly software, which hinders practical utilization of these functional methods. We fill this knowledge gap and develop the R package FunctanSNP. This comprehensive package encompasses estimation, identification, and visualization tools and has undergone extensive testing using both simulated and real data, confirming its reliability. FunctanSNP can serve as a convenient and reliable tool for analyzing SNP and other densely measured data. AVAILABILITY AND IMPLEMENTATION: The package is available at https://CRAN.R-project.org/package=FunctanSNP.


Assuntos
Software , Reprodutibilidade dos Testes
2.
Bioinformatics ; 38(11): 3134-3135, 2022 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-35441661

RESUMO

SUMMARY: In the analysis of high-dimensional omics data, dimension reduction techniques-including principal component analysis (PCA), partial least squares (PLS) and canonical correlation analysis (CCA)-have been extensively used. When there are multiple datasets generated by independent studies with compatible designs, integrative analysis has been developed and shown to outperform meta-analysis, other multidatasets analysis, and individual-data analysis. To facilitate integrative dimension reduction analysis in daily practice, we develop the R package iSFun, which can comprehensively conduct integrative sparse PCA, PLS and CCA, as well as meta-analysis and stacked analysis. The package can conduct analysis under the homogeneity and heterogeneity models and with the magnitude- and sign-based contrasted penalties. As a 'byproduct', this article is the first to develop integrative analysis built on the CCA technique, further expanding the scope of integrative analysis. AVAILABILITY AND IMPLEMENTATION: The package is available at https://CRAN.R-project.org/package=iSFun. SUPPLEMENTARY INFORMATION: Supplementary materials are available at Bioinformatics online.


Assuntos
Software , Análise dos Mínimos Quadrados , Análise de Componente Principal
3.
Biometrics ; 79(4): 3883-3894, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37132273

RESUMO

Gene-environment (G-E) interactions have important implications for cancer outcomes and phenotypes beyond the main G and E effects. Compared to main-effect-only analysis, G-E interaction analysis more seriously suffers from a lack of information caused by higher dimensionality, weaker signals, and other factors. It is also uniquely challenged by the "main effects, interactions" variable selection hierarchy. Effort has been made to bring in additional information to assist cancer G-E interaction analysis. In this study, we take a strategy different from the existing literature and borrow information from pathological imaging data. Such data are a "byproduct" of biopsy, enjoys broad availability and low cost, and has been shown as informative for modeling prognosis and other cancer outcomes/phenotypes in recent studies. Building on penalization, we develop an assisted estimation and variable selection approach for G-E interaction analysis. The approach is intuitive, can be effectively realized, and has competitive performance in simulation. We further analyze The Cancer Genome Atlas (TCGA) data on lung adenocarcinoma (LUAD). The outcome of interest is overall survival, and for G variables, we analyze gene expressions. Assisted by pathological imaging data, our G-E interaction analysis leads to different findings with competitive prediction performance and stability.


Assuntos
Interação Gene-Ambiente , Neoplasias , Humanos , Neoplasias/genética , Simulação por Computador , Fenótipo , Modelos Genéticos
4.
Stat Med ; 42(10): 1565-1582, 2023 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-36825602

RESUMO

Clustering for multivariate functional data is a challenging problem since the data are represented by a set of curves and functions belonging to an infinite-dimensional space. In this article, we propose a novel clustering method for multivariate functional data using an adaptive density peak detection technique. It is a quick cluster center identification algorithm based on the two measures of each functional data observation: the functional density estimate and the distance to the closest observation with a higher functional density. We suggest two types of functional density estimators for multivariate functional data. The first one is a functional k $$ k $$ -nearest neighbor density estimator based on (a) an L2 distance between raw functional curves, or (b) a semimetric of multivariate functional principal components. The second one is a k $$ k $$ -nearest neighbor density estimator based on multivariate functional principal scores. Our clustering method is computationally fast since it does not need an iterative process. The flexibility and advantages of the method are examined by comparing it with other existing clustering methods in simulation studies. A user-friendly R package FADPclust is developed for public use. Finally, our method is applied to a real case study in lung cancer research.


Assuntos
Algoritmos , Humanos , Análise por Conglomerados , Simulação por Computador
5.
J Hepatol ; 75(3): 547-556, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33961940

RESUMO

BACKGROUND & AIMS: Acute viral hepatitis (AVH) represents an important global health problem; however, the progress in understanding AVH is limited because of the priority of combating persistent HBV and HCV infections. Therefore, an improved understanding of the burden of AVH is required to help design strategies for global intervention. METHODS: Data on 4 major AVH types, including acute hepatitis A, B, C, and E, excluding D, were collected by the Global Burden of Disease (GBD) 2019 database. Age-standardized incidence rates and disability-adjusted life year (DALY) rates for AVH were extracted from GBD 2019 and stratified by sex, level of socio-demographic index (SDI), country, and territory. The association between the burden of AVH and socioeconomic development status, as represented by the SDI, was described. RESULTS: In 2019, there was an age-standardized incidence rate of 3,615.9 (95% CI 3,360.5-3,888.3) and an age-standardized DALY rate of 58.0 (47.3-70.0) per 100,000 person-years for the 4 major types of AVH. Among the major AVH types, acute hepatitis A caused the heaviest burden. There was a significant downward trend in age-standardized DALY rates caused by major incidences of AVH between 1990 and 2019. In 2019, regions or countries located in West and East Africa exhibited the highest age-standardized incidence rates of the 4 major AVH types. These rates were stratified by SDI: high SDI and high-middle SDI locations recorded the lowest incidence and DALY rates of AVH, whereas the low-middle SDI and low SDI locations showed the highest burden of AVH. CONCLUSIONS: The socioeconomic development status and burden of AVH are associated. Therefore, the GBD 2019 data should be used by policymakers to guide cost-effective interventions for AVH. LAY SUMMARY: We identified a negative association between socioeconomic development status and the burden of acute viral hepatitis. The lowest burden of acute viral hepatitis was noted for rich countries, whereas the highest burden of acute viral hepatitis was noted for poor countries.


Assuntos
Carga Global da Doença/tendências , Hepatite Viral Humana/diagnóstico , Classe Social , Países em Desenvolvimento/estatística & dados numéricos , Anos de Vida Ajustados por Deficiência/tendências , Hepatite Viral Humana/epidemiologia , Humanos , Incidência , Anos de Vida Ajustados por Qualidade de Vida
6.
Stat Med ; 39(7): 955-967, 2020 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-31880351

RESUMO

This article is motivated by a study of lung cancer prediction using breath volatile organic compound (VOC) biomarkers, where the challenge is that the predictors include not only high-dimensional time-dependent or functional VOC features but also the time-independent clinical variables. We consider a high-dimensional logistic regression and propose two different penalties: group spline-penalty or group smooth-penalty to handle the group structures of the time-dependent variables in the model. The new methods have the advantage for the situation where the model coefficients are sparse but change smoothly within the group, compared with other existing methods such as the group lasso and the group bridge approaches. Our methods are easy to implement since they can be turned into a group minimax concave penalty problem after certain transformations. We show that our fitting algorithm possesses the descent property and leads to attractive convergence properties. The simulation studies and the lung cancer application are performed to demonstrate the accuracy and stability of the proposed approaches.


Assuntos
Algoritmos , Neoplasias Pulmonares , Biomarcadores , Simulação por Computador , Humanos , Modelos Logísticos , Neoplasias Pulmonares/diagnóstico
7.
Stat Med ; 39(2): 146-155, 2020 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-31749227

RESUMO

In the analysis of complex and high-dimensional data, graphical models have been commonly adopted to describe associations among variables. When common factors exist which make the associations dense, the single factor graphical model has been proposed, which first extracts the common factor and then conducts graphical modeling. Under other simpler contexts, it has been recognized that results generated from analyzing a single dataset are often unsatisfactory, and integrating multiple datasets can effectively improve variable selection and estimation. In graphical modeling, the increased number of parameters makes the "lack of information" problem more severe. In this article, we integrate multiple datasets and conduct the approximate single factor graphical model analysis. A novel penalization approach is developed for the identification and estimation of important loadings and edges. An effective computational algorithm is developed. A wide spectrum of simulations and the analysis of breast cancer gene expression datasets demonstrate the competitive performance of the proposed approach. Overall, this study provides an effective new venue for taking advantage of multiple datasets and improving graphical model analysis.


Assuntos
Gráficos por Computador , Modelos Estatísticos , Algoritmos , Simulação por Computador , Humanos
8.
Artigo em Inglês | MEDLINE | ID: mdl-32863493

RESUMO

The finite mixture of regression (FMR) model is a popular tool for accommodating data heterogeneity. In the analysis of FMR models with high-dimensional covariates, it is necessary to conduct regularized estimation and identify important covariates rather than noises. In the literature, there has been a lack of attention paid to the differences among important covariates, which can lead to the underlying structure of covariate effects. Specifically, important covariates can be classified into two types: those that behave the same in different subpopulations and those that behave differently. It is of interest to conduct structured analysis to identify such structures, which will enable researchers to better understand covariates and their associations with outcomes. Specifically, the FMR model with high-dimensional covariates is considered. A structured penalization approach is developed for regularized estimation, selection of important variables, and, equally importantly, identification of the underlying covariate effect structure. The proposed approach can be effectively realized, and its statistical properties are rigorously established. Simulation demonstrates its superiority over alternatives. In the analysis of cancer gene expression data, interesting models/structures missed by the existing analysis are identified.

9.
J Stat Comput Simul ; 90(2): 341-354, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33012883

RESUMO

Functional data analysis has attracted substantial research interest and the goal of functional sparsity is to produce a sparse estimate which assigns zero values over regions where the true underlying function is zero, i.e., no relationship between the response variable and the predictor variable. In this paper, we consider a functional linear regression models that explicitly incorporates the interconnections among the responses. We propose a locally sparse (i.e., zero on some subregions) estimator, multiple-smooth and locally sparse (m-SLoS) estimator, for coefficient functions base on the interconnections among the responses. This method is based on a combination of smooth and locally sparse (SLoS) estimator and Laplacian quadratic penalty function, where we used SLoS for encouraging locally sparse and Laplacian quadratic penalty for promoting similar locally sparse among coefficient functions associated with the interconnections among the responses. Simulations show excellent numerical performance of the proposed method in terms of the estimation of coefficient functions especially the coefficient functions are same for all multivariate responses. Practical merit of this modeling is demonstrated by one real application and the prediction shows significant improvements.

10.
Stat Med ; 38(13): 2364-2380, 2019 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-30854706

RESUMO

The analysis of gene expression data has been playing a pivotal role in recent biomedical research. For gene expression data, network analysis has been shown to be more informative and powerful than individual-gene and geneset-based analysis. Despite promising successes, with the high dimensionality of gene expression data and often low sample sizes, network construction with gene expression data is still often challenged. In recent studies, a prominent trend is to conduct multidimensional profiling, under which data are collected on gene expressions as well as their regulators (copy number variations, methylation, microRNAs, SNPs, etc). With the regulation relationship, regulators contain information on gene expressions and can potentially assist in estimating their characteristics. In this study, we develop an assisted graphical model (AGM) approach, which can effectively use information in regulators to improve the estimation of gene expression graphical structure. The proposed approach has an intuitive formulation and can adaptively accommodate different regulator scenarios. Its consistency properties are rigorously established. Extensive simulations and the analysis of a breast cancer gene expression data set demonstrate the practical effectiveness of the AGM.


Assuntos
Neoplasias da Mama/genética , Perfilação da Expressão Gênica/estatística & dados numéricos , Modelos Estatísticos , Variações do Número de Cópias de DNA , Feminino , Humanos , MicroRNAs/genética
11.
Genet Epidemiol ; 41(8): 844-865, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29114920

RESUMO

In the analysis of gene expression data, dimension reduction techniques have been extensively adopted. The most popular one is perhaps the PCA (principal component analysis). To generate more reliable and more interpretable results, the SPCA (sparse PCA) technique has been developed. With the "small sample size, high dimensionality" characteristic of gene expression data, the analysis results generated from a single dataset are often unsatisfactory. Under contexts other than dimension reduction, integrative analysis techniques, which jointly analyze the raw data of multiple independent datasets, have been developed and shown to outperform "classic" meta-analysis and other multidatasets techniques and single-dataset analysis. In this study, we conduct integrative analysis by developing the iSPCA (integrative SPCA) method. iSPCA achieves the selection and estimation of sparse loadings using a group penalty. To take advantage of the similarity across datasets and generate more accurate results, we further impose contrasted penalties. Different penalties are proposed to accommodate different data conditions. Extensive simulations show that iSPCA outperforms the alternatives under a wide spectrum of settings. The analysis of breast cancer and pancreatic cancer data further shows iSPCA's satisfactory performance.


Assuntos
Modelos Genéticos , Algoritmos , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/patologia , Análise de Componente Principal
12.
Biom J ; 59(2): 358-376, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27870109

RESUMO

Data with a large p (number of covariates) and/or a large n (sample size) are now commonly encountered. For many problems, regularization especially penalization is adopted for estimation and variable selection. The straightforward application of penalization to large datasets demands a "big computer" with high computational power. To improve computational feasibility, we develop bootstrap penalization, which dissects a big penalized estimation into a set of small ones, which can be executed in a highly parallel manner and each only demands a "small computer". The proposed approach takes different strategies for data with different characteristics. For data with a large p but a small to moderate n, covariates are first clustered into relatively homogeneous blocks. The proposed approach consists of two sequential steps. In each step and for each bootstrap sample, we select blocks of covariates and run penalization. The results from multiple bootstrap samples are pooled to generate the final estimate. For data with a large n but a small to moderate p, we bootstrap a small number of subjects, apply penalized estimation, and then conduct a weighted average over multiple bootstrap samples. For data with a large p and a large n, the natural marriage of the previous two methods is applied. Numerical studies, including simulations and data analysis, show that the proposed approach has computational and numerical advantages over the straightforward application of penalization. An R package has been developed to implement the proposed methods.


Assuntos
Simulação por Computador , Interpretação Estatística de Dados , Humanos , Modelos Estatísticos , Tamanho da Amostra , Software
13.
BMC Public Health ; 13: 743, 2013 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-23938071

RESUMO

BACKGROUND: Illness conditions lead to medical expenditure. Even with various types of medical insurance, there can still be considerable out-of-pocket costs. Medical expenditure can affect other categories of household consumptions. The goal of this study is to provide an updated empirical description of the distributions of illness conditions and medical expenditure and their associations with other categories of household consumptions. METHODS: A phone-call survey was conducted in June and July of 2012. The study was approved by ethics review committees at Xiamen University and FuJen Catholic University. Data was collected using a Computer-Assisted Telephone Survey System (CATSS). "Household" was the unit for data collection and analysis. Univariate and multivariate analyses were conducted, examining the distributions of illness conditions and the associations of illness and medical expenditure with other household consumptions. RESULTS: The presence of chronic disease and inpatient treatment was not significantly associated with household characteristics. The level of per capita medical expenditure was significantly associated with household size, income, and household head occupation. The presence of chronic disease was significantly associated with levels of education, insurance and durable goods consumption. After adjusting for confounders, the associations with education and durable goods consumption remained significant. The presence of inpatient treatment was not associated with consumption levels. In the univariate analysis, medical expenditure was significantly associated with all other consumption categories. After adjusting for confounding effects, the associations between medical expenditure and the actual amount of entertainment expenses and percentages of basic consumption, savings, and insurance (as of total consumption) remained significant. CONCLUSION: This study provided an updated description of the distributions of illness conditions and medical expenditure in Taiwan. The findings were mostly positive in that illness and medical expenditure were not observed to be significantly associated with other consumption categories. This observation differed from those made in some other Asian countries and could be explained by the higher economic status and universal basic health insurance coverage of Taiwan.


Assuntos
Efeitos Psicossociais da Doença , Características da Família , Gastos em Saúde/estatística & dados numéricos , Pesquisa Empírica , Humanos , Taiwan
14.
Genet Res (Camb) ; 94(4): 205-21, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22950901

RESUMO

High-throughput gene profiling studies have been extensively conducted, searching for markers associated with cancer development and progression. In this study, we analyse cancer prognosis studies with right censored survival responses. With gene expression data, we adopt the weighted gene co-expression network analysis (WGCNA) to describe the interplay among genes. In network analysis, nodes represent genes. There are subsets of nodes, called modules, which are tightly connected to each other. Genes within the same modules tend to have co-regulated biological functions. For cancer prognosis data with gene expression measurements, our goal is to identify cancer markers, while properly accounting for the network module structure. A two-step sparse boosting approach, called Network Sparse Boosting (NSBoost), is proposed for marker selection. In the first step, for each module separately, we use a sparse boosting approach for within-module marker selection and construct module-level 'super markers'. In the second step, we use the super markers to represent the effects of all genes within the same modules and conduct module-level selection using a sparse boosting approach. Simulation study shows that NSBoost can more accurately identify cancer-associated genes and modules than alternatives. In the analysis of breast cancer and lymphoma prognosis studies, NSBoost identifies genes with important biological implications. It outperforms alternatives including the boosting and penalization approaches by identifying a smaller number of genes/modules and/or having better prediction performance.


Assuntos
Biomarcadores Tumorais/genética , Neoplasias da Mama , Carcinoma , Redes Reguladoras de Genes/genética , Algoritmos , Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/genética , Carcinoma/diagnóstico , Carcinoma/genética , Biologia Computacional/métodos , Feminino , Perfilação da Expressão Gênica , Humanos , Modelos Estatísticos , Valor Preditivo dos Testes , Prognóstico
15.
BMC Health Serv Res ; 12: 442, 2012 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-23206690

RESUMO

BACKGROUND: The health insurance system in Taiwan is comprised of public health insurance and private health insurance. The public health insurance, called "universal national health insurance" (NHI), was first established in 1995 and amended in 2011. The goal of this study is to provide an updated description of several important aspects of health insurance in Taiwan. Of special interest are household insurance coverage, medical expenditures (both gross and out-of-pocket), and coping strategies. METHODS: Data was collected via a phone call survey conducted in August and September of 2011. A household was the unit for survey and data analysis. A total of 2,424 households covering all major counties and cities in Taiwan were surveyed. RESULTS: The survey revealed that households with smaller sizes and higher incomes were more likely to have higher coverage of public and private health insurance. In addition, households with the presence of chronic diseases were more likely to have both types of insurance. Analysis of both gross and out-of-pocket medical expenditure was conducted. It was suggested that health insurance could not fully remove the financial burden caused by illness. The presence of chronic disease and inpatient treatment were significantly associated with higher gross and out-of-pocket medical expenditure. In addition, the presence of inpatient treatment was significantly associated with extremely high medical expenditure. Regional differences were also observed, with households in the northern, central, and southern regions having less gross medical expenditures than those on the offshore islands. Households with the presence of inpatient treatment were more likely to cope with medical expenditure using means other than salaries. CONCLUSION: Despite the considerable achievements of the health insurance system in Taiwan, there is still room for improvement. This study investigated coverage, cost, and coping strategies and may be informative to stakeholders of both basic and commercial health insurance.


Assuntos
Gastos em Saúde/estatística & dados numéricos , Seguro Saúde/economia , Cobertura Universal do Seguro de Saúde/economia , Adaptação Psicológica , Coleta de Dados , Características da Família , Financiamento Pessoal/economia , Financiamento Pessoal/estatística & dados numéricos , Humanos , Renda , Cobertura do Seguro/economia , Cobertura do Seguro/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Modelos Logísticos , Taiwan , Cobertura Universal do Seguro de Saúde/estatística & dados numéricos
16.
J Appl Stat ; 49(5): 1105-1120, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35707509

RESUMO

In the application of high-dimensional data classification, several attempts have been made to achieve variable selection by replacing the ℓ 2 -penalty with other penalties for the support vector machine (SVM). However, these high-dimensional SVM methods usually do not take into account the special structure among covariates (features). In this article, we consider a classification problem, where the covariates are ordered in some meaningful way, and the number of covariates p can be much larger than the sample size n. We propose a structured sparse SVM to tackle this type of problems, which combines the non-convex penalty and cubic spline estimation procedure (i.e. penalizing second-order derivatives of the coefficients) to the SVM. From a theoretical point of view, the proposed method satisfies the local oracle property. Simulations show that the method works effectively both in feature selection and classification accuracy. A real application is conducted to illustrate the benefits of the method.

17.
J Multivar Anal ; 1892022 May.
Artigo em Inglês | MEDLINE | ID: mdl-36817965

RESUMO

In biomedical data analysis, clustering is commonly conducted. Biclustering analysis conducts clustering in both the sample and covariate dimensions and can more comprehensively describe data heterogeneity. In most of the existing biclustering analyses, scalar measurements are considered. In this study, motivated by time-course gene expression data and other examples, we take the "natural next step" and consider the biclustering analysis of functionals under which, for each covariate of each sample, a function (to be exact, its values at discrete measurement points) is present. We develop a doubly penalized fusion approach, which includes a smoothness penalty for estimating functionals and, more importantly, a fusion penalty for clustering. Statistical properties are rigorously established, providing the proposed approach a strong ground. We also develop an effective ADMM algorithm and accompanying R code. Numerical analysis, including simulations, comparisons, and the analysis of two time-course gene expression data, demonstrates the practical effectiveness of the proposed approach.

18.
Stat Med ; 30(28): 3361-71, 2011 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-22105693

RESUMO

Although in cancer research microarray gene profiling studies have been successful in identifying genetic variants predisposing to the development and progression of cancer, the identified markers from analysis of single datasets often suffer low reproducibility. Among multiple possible causes, the most important one is the small sample size hence the lack of power of single studies. Integrative analysis jointly considers multiple heterogeneous studies, has a significantly larger sample size, and can improve reproducibility. In this article, we focus on cancer prognosis studies, where the response variables are progression-free, overall, or other types of survival. A group minimax concave penalty (GMCP) penalized integrative analysis approach is proposed for analyzing multiple heterogeneous cancer prognosis studies with microarray gene expression measurements. An efficient group coordinate descent algorithm is developed. The GMCP can automatically accommodate the heterogeneity across multiple datasets, and the identified markers have consistent effects across multiple studies. Simulation studies show that the GMCP provides significantly improved selection results as compared with the existing meta-analysis approaches, intensity approaches, and group Lasso penalized integrative analysis. We apply the GMCP to four microarray studies and identify genes associated with the prognosis of breast cancer.


Assuntos
Perfilação da Expressão Gênica , Modelos Estatísticos , Neoplasias/diagnóstico , Neoplasias/genética , Algoritmos , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/genética , Simulação por Computador , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Estimativa de Kaplan-Meier , Análise dos Mínimos Quadrados , Metanálise como Assunto , Análise de Sequência com Séries de Oligonucleotídeos , Prognóstico , Tamanho da Amostra , Análise de Sobrevida
19.
Zhonghua Gan Zang Bing Za Zhi ; 19(10): 738-42, 2011 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-22409844

RESUMO

OBJECTIVE: To establish a predictive scoring system which may serve for the prediction of sustained response to conventional interferon-alpha (IFN-alpha) treatment on chronic hepatitis B. METHODS: A total of 474 IFN-alpha treated hepatitis B virus e antigen (HBeAg)-positive patients were enrolled in the present study. The patients' baseline characteristics, such as age, gender, aminotransferases, activity grading (G) of intrahepatic inflammation, score (S) of liver fibrosis, hepatitis B virus (HBV) DNA and genotype were evaluated; therapy duration and response of each patient at the 24th wk after cessation of IFN-alpha treatment were also recorded. A predictive scoring system for a sustained complete response (CR) to IFN-alpha therapy was established based on genetic algorithm. About 10% of the patients were randomly drawn out as the test set. Responses to IFN-alpha therapy were divided into CR, partial response (PR) and non-response (NR). The mixed set of PR and NR was recorded as PR + NR. RESULTS: For the scoring system, the sensitivity and specificity were 78.8% and 80.6%, respectively. CONCLUSION: This SCR scoring system has satisfying prediction efficiency and is easily employed in clinical practice. With this scoring system, practitioners can propose individualized decisions that have an integrated foundation on both evidence-based medicine and personal characteristics.


Assuntos
Antivirais/uso terapêutico , Hepatite B Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Adolescente , Adulto , Criança , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Sensibilidade e Especificidade , Resultado do Tratamento , Adulto Jovem
20.
JMIR Public Health Surveill ; 6(4): e25174, 2020 12 23.
Artigo em Inglês | MEDLINE | ID: mdl-33315585

RESUMO

BACKGROUND: Different states in the United States had different nonpharmaceutical public health interventions during the COVID-19 pandemic. The effects of those interventions on hospital use have not been systematically evaluated. The investigation could provide data-driven evidence to potentially improve the implementation of public health interventions in the future. OBJECTIVE: We aim to study two representative areas in the United States and one area in China (New York State, Ohio State, and Hubei Province), and investigate the effects of their public health interventions by time periods according to key interventions. METHODS: This observational study evaluated the numbers of infected, hospitalized, and death cases in New York and Ohio from March 16 through September 14, 2020, and Hubei from January 26 to March 31, 2020. We developed novel Bayesian generalized compartmental models. The clinical stages of COVID-19 were stratified in the models, and the effects of public health interventions were modeled through piecewise exponential functions. Time-dependent transmission rates and effective reproduction numbers were estimated. The associations of interventions and the numbers of required hospital and intensive care unit beds were studied. RESULTS: The interventions of social distancing, home confinement, and wearing masks significantly decreased (in a Bayesian sense) the case incidence and reduced the demand for beds in all areas. Ohio's transmission rates declined before the state's "stay at home" order, which provided evidence that early intervention is important. Wearing masks was significantly associated with reducing the transmission rates after reopening, when comparing New York and Ohio. The centralized quarantine intervention in Hubei played a significant role in further preventing and controlling the disease in that area. The estimated rates that cured patients become susceptible in all areas were small (<0.0001), which indicates that they have little chance to get the infection again. CONCLUSIONS: The series of public health interventions in three areas were temporally associated with the burden of COVID-19-attributed hospital use. Social distancing and the use of face masks should continue to prevent the next peak of the pandemic.


Assuntos
COVID-19/prevenção & controle , COVID-19/terapia , Hospitalização/estatística & dados numéricos , Prática de Saúde Pública/estatística & dados numéricos , Teorema de Bayes , COVID-19/epidemiologia , China/epidemiologia , Humanos , Máscaras/estatística & dados numéricos , Modelos Estatísticos , Distanciamento Físico , Quarentena/estatística & dados numéricos , Estados Unidos/epidemiologia
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