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arXiv 2408.03463stat.MEcs.AI
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在观察性时间到事件数据中识别治疗反应亚组

Identifying treatment response subgroups in observational time-to-event data

University of Cambridge(剑桥大学);The Alan Turing Institute(艾伦·图灵研究所);University of Oxford(牛津大学)

Vincent Jeanselme, Chang Ho Yoon, Fabian Falck, Brian Tom, Jessica Barrett

AI总结:

本文提出了一种基于结果导向的亚组分析策略,用于在随机对照试验和观察性研究中识别治疗反应不同的患者亚组,从而提升医疗决策的精准性。

摘要:

识别具有不同治疗反应的患者亚组是一项重要的任务,以指导医疗建议、指南以及未来临床试验的设计。现有的治疗效应估计方法主要依赖于随机对照试验(RCTs),这些试验通常具有更同质的患者群体,使其在揭示现实世界临床实践中遇到的人群亚组时不太相关。为RCTs建立的亚组分析在应用于观察性研究时会遭受显著的统计偏倚,因为观察性研究受益于更大的、更具代表性的总体。我们的工作介绍了一种新的、以结果为导向的亚组分析策略,用于在RCTs和观察性研究中识别治疗反应的亚组。因此,它在个体化和平均治疗效应估计之间定位,以揭示具有不同治疗反应的患者亚组,这对于影响治疗指南的可操作见解至关重要。在实验中,我们的方法在随机和观察性治疗制度中均显著优于当前最先进的亚组分析方法。

英文摘要:

Identifying patient subgroups with different treatment responses is an important task to inform medical recommendations, guidelines, and the design of future clinical trials. Existing approaches for treatment effect estimation primarily rely on Randomised Controlled Trials (RCTs), which tend to feature more homogeneous patient groups, making them less relevant for uncovering subgroups in the population encountered in real-world clinical practice. Subgroup analyses established for RCTs suffer from significant statistical biases when applied to observational studies, which benefit from larger and more representative populations. Our work introduces a novel, outcome-guided, subgroup analysis strategy for identifying subgroups of treatment response in both RCTs and observational studies alike. It hence positions itself in-between individualised and average treatment effect estimation to uncover patient subgroups with distinct treatment responses, critical for actionable insights that may influence treatment guidelines. In experiments, our approach significantly outperforms the current state-of-the-art method for subgroup analysis in both randomised and observational treatment regimes.

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

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