Early diagnosis of gestational trophoblastic neoplasia based on trajectory classification with compartment modeling

BMC Medical Research Methodology - Tập 16 - Trang 1-10 - 2016
Claire Burny1,2,3,4, Muriel Rabilloud1,2,3,4, François Golfier2,3,5,6, Jérôme Massardier6,7, Touria Hajri2,3,6,8, Anne-Marie Schott2,3,8, Fabien Subtil1,2,3,4
1Service de Biostatistique, Hospices Civils de Lyon, Lyon, France
2Université de Lyon, Lyon, France
3Université Lyon 1, Villeurbanne, France
4CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France
5Department of Gynaecological and Oncological Surgery-Obstetrics, Lyon Sud University Hospital, Lyon, France
6French Trophoblastic Disease Reference Centre, Lyon Sud University Hospital, Lyon, France
7Department of Obstetrics, University Hospital Femme-Mère-Enfant, Lyon, France
8Pôle Information Médicale Evaluation Recherche, Equipe d’Accueil 4129, Hospices Civils de Lyon, Lyon, France

Tóm tắt

In randomized clinical trials or observational studies, it is common to collect biomarker values longitudinally on a cohort of individuals. The investigators may be interested in grouping individuals that share similar changes of biomarker values and use these groups for diagnosis or therapeutic purposes. However, most classical model-based classification methods rely mainly on empirical models such as splines or polynomials and do not reflect the physiological processes. A model-based classification method was developed for longitudinal biomarker measurements through a pharmacokinetic model that describes biomarker changes over time. The method is illustrated using data on human Chorionic Gonadotrophic Hormone measurements after curettage of hydatidiform moles. The resulting classification was linked to the evolution toward gestational trophoblastic neoplasia and may be used as a tool for early diagnosis. The diagnostic accuracy of the pharmacokinetic model was more reproducible than the one of a purely mathematical model that did not take into account the biological processes. The use of pharmacokinetic models in model-based classification approaches can lead to clinically useful classifications.

Tài liệu tham khảo

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