Comparing Individualized Survival Predictions From Random Survival Forests and Multistate Models in the Presence of Missing Data: A Case Study of Patients With Oropharyngeal Cancer.

Autor: Abbott MR; Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA., Beesley LJ; Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA.; Information Systems & Modeling, Los Alamos National Laboratory, Los Alamos, NM, USA., Bellile EL; Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA., Shuman AG; Department of Otolaryngology, University of Michigan, Ann Arbor, MI, USA., Rozek LS; Department of Oncology, Georgetown University School of Medicine, Washington, DC, USA., Taylor JMG; Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
Jazyk: angličtina
Zdroj: Cancer informatics [Cancer Inform] 2023 Jun 29; Vol. 22, pp. 11769351231183847. Date of Electronic Publication: 2023 Jun 29 (Print Publication: 2023).
DOI: 10.1177/11769351231183847
Abstrakt: Background: In recent years, interest in prognostic calculators for predicting patient health outcomes has grown with the popularity of personalized medicine. These calculators, which can inform treatment decisions, employ many different methods, each of which has advantages and disadvantages.
Methods: We present a comparison of a multistate model (MSM) and a random survival forest (RSF) through a case study of prognostic predictions for patients with oropharyngeal squamous cell carcinoma. The MSM is highly structured and takes into account some aspects of the clinical context and knowledge about oropharyngeal cancer, while the RSF can be thought of as a black-box non-parametric approach. Key in this comparison are the high rate of missing values within these data and the different approaches used by the MSM and RSF to handle missingness.
Results: We compare the accuracy (discrimination and calibration) of survival probabilities predicted by both approaches and use simulation studies to better understand how predictive accuracy is influenced by the approach to (1) handling missing data and (2) modeling structural/disease progression information present in the data. We conclude that both approaches have similar predictive accuracy, with a slight advantage going to the MSM.
Conclusions: Although the MSM shows slightly better predictive ability than the RSF, consideration of other differences are key when selecting the best approach for addressing a specific research question. These key differences include the methods' ability to incorporate domain knowledge, and their ability to handle missing data as well as their interpretability, and ease of implementation. Ultimately, selecting the statistical method that has the most potential to aid in clinical decisions requires thoughtful consideration of the specific goals.
Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
(© The Author(s) 2023.)
Databáze: MEDLINE
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