Prediction-based classification for longitudinal biomarkers

DOI10.1214/10-AOAS326MaRDI QIDQ614167zbMATH OpenOpenAlexWikidataFDO

Authors Andrea S. Foulkes, Livio Azzoni, Xiaohong Li, Margaret A. Johnson, Colette Smith, Karam Mounzer, Luis J. Montaner

Publication date 27 December 2010

Published in The Annals of Applied Statistics (Search for Journal in Brave)

Full work available at URL https://arxiv.org/abs/1011.3351

zbMATH Keywords

CD4classificationgeneralized linear mixed effects modeling (GLMM)HIV/AIDSpredictionreceiver operator characteristic (ROC) curve

Mathematics Subject Classification ID

Classification and discrimination; cluster analysis (statistical aspects) (62H30) Applications of statistics to biology and medical sciences; meta analysis (62P10) Medical applications (general) (92C50)

Abstract: Assessment of circulating CD4 count change over time in HIV-infected subjects on antiretroviral therapy (ART) is a central component of disease monitoring. The increasing number of HIV-infected subjects starting therapy and the limited capacity to support CD4 count testing within resource-limited settings have fueled interest in identifying correlates of CD4 count change such as total lymphocyte count, among others. The application of modeling techniques will be essential to this endeavor due to the typically nonlinear CD4 trajectory over time and the multiple input variables necessary for capturing CD4 variability. We propose a prediction-based classification approach that involves first stage modeling and subsequent classification based on clinically meaningful thresholds. This approach draws on existing analytical methods described in the receiver operating characteristic curve literature while presenting an extension for handling a continuous outcome. Application of this method to an independent test sample results in greater than 98% positive predictive value for CD4 count change. The prediction algorithm is derived based on a cohort of $n=270$ HIV-1 infected individuals from the Royal Free Hospital, London who were followed for up to three years from initiation of ART. A test sample comprised of $n=72$ individuals from Philadelphia and followed for a similar length of time is used for validation. Results suggest that this approach may be a useful tool for prioritizing limited laboratory resources for CD4 testing after subjects start antiretroviral therapy.

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Cites work

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Cited in

(9)

• Improving the classification accuracy using biomarkers selected from machine learning methods
• A tutorial on dynamic risk prediction of a binary outcome based on a longitudinal biomarker
• Classification of therapy resistance based on longitudinal biomarker profiles
• Optimal allocation of gold standard testing under constrained availability: application to assessment of HIV treatment failure
• Prospective Accuracy for Longitudinal Markers
• Bayesian semiparametric joint modeling of longitudinal explanatory variables of mixed types and a binary outcome
• Combining biomarker trajectories to improve diagnostic accuracy in prospective cohort studies with verification bias
• Shared random parameter models: a legacy of the biostatistics program at the National Heart, Lung, and Blood Institute
• Dynamic predictive probabilities to monitor rapid cystic fibrosis disease progression

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