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arXiv 1502.00757stat.AP
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在潜在结果框架下使用协变量和随机效应评估预测性生物标志物

The use of covariates and random effects in evaluating predictive biomarkers under a potential outcome framework

Zhiwei Zhang, Lei Nie, Guoxing Soon, Aiyi Liu

摘要:

预测性或治疗选择性生物标志物通常在亚组或回归分析中进行评价,重点是治疗与标志物的相互作用。在潜在结局框架下(Huang,Gilbert和Janes [Biometrics 68(2012)687-696]),预测性生物标志物被视为预期治疗获益的预测因子(通过比较不同治疗的潜在结局定义),并使用预测和分类中的熟悉概念进行评价。然而,所需的治疗益处是不可观察的,因为在典型的研究中,每个患者只能接受一种治疗。Huang等人通过假设潜在结局的单调性克服了这个问题,在所有患者中一种治疗优于另一种治疗。受一个似乎违反单调性假设的HIV例子的启发,我们提出了一种基于协变量和随机效应的不同方法,用于在潜在结果框架下评估预测性生物标志物。在所提出的方法下,可以通过假设潜在结果的条件独立性来确定感兴趣的参数,给定观察到的协变量,并且可以通过合并未观察到的随机效应来执行敏感性分析,该随机效应解释了任何剩余依赖性。将这种方法应用于激励性实例表明,基线病毒载量和CD 4细胞计数都可用作为初治患者选择抗逆转录病毒药物的预测性生物标志物。

英文摘要:

Predictive or treatment selection biomarkers are usually evaluated in a subgroup or regression analysis with focus on the treatment-by-marker interaction. Under a potential outcome framework (Huang, Gilbert and Janes [Biometrics 68 (2012) 687-696]), a predictive biomarker is considered a predictor for a desirable treatment benefit (defined by comparing potential outcomes for different treatments) and evaluated using familiar concepts in prediction and classification. However, the desired treatment benefit is unobservable because each patient can receive only one treatment in a typical study. Huang et al. overcome this problem by assuming monotonicity of potential outcomes, with one treatment dominating the other in all patients. Motivated by an HIV example that appears to violate the monotonicity assumption, we propose a different approach based on covariates and random effects for evaluating predictive biomarkers under the potential outcome framework. Under the proposed approach, the parameters of interest can be identified by assuming conditional independence of potential outcomes given observed covariates, and a sensitivity analysis can be performed by incorporating an unobserved random effect that accounts for any residual dependence. Application of this approach to the motivating example shows that baseline viral load and CD4 cell count are both useful as predictive biomarkers for choosing antiretroviral drugs for treatment-naive patients.

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