利用患者报告的长度结果轨迹来预测非小细胞肺癌的生存率
Jiawei Zhou1, Benyam Muluneh1, Zhaoyang Wang2
1University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
概括
在非小细胞肺癌 (NSCLC) 中,长度患者报告结果 (PRO) 分析揭示了预后见解. PRO动态有效预测存活率,增强以患者为中心的护理策略.
科学领域:
- 在瘤学瘤学.
- 生物统计学 生物统计学
- 患者报告的研究结果研究结果
背景情况:
- 患者报告结果 (PRO) 在临床决策中未得到充分利用,特别是当与临床结果不一致时.
- 现有的分析方法往往无法捕捉PRO数据固有的时间动态和变化.
- 需要新的方法来利用纵向PRO数据来获得非小细胞肺癌 (NSCLC) 的预后见解.
研究的目的:
- 开发和验证一种用于分析纵向PRO动态的新方法.
- 在NSCLC患者中调查肺癌症状尺度 (LCSS) 的预后价值.
- 评估PRO参数在预测生存结果中的有用性.
主要方法:
- 从481名NSCLC参与者 (安慰剂组) 的纵向LCSS数据使用人口建模方法进行分析.
- 模拟了PRO的进展轨迹,考虑到数据的变化.
- 评估了PRO模型参数和生存之间的关联,使用Cox比例危险模型和机器学习来预测生存.
主要成果:
- 一个PRO进展模型描述了LCSS动态,预测症状进展的中位时间为229天.
- 较快的PRO进展率与较差的生存率有关 (HR 1.13),而改善的PRO效应与更好的生存率相关 (HR 0.93).
- 使用PRO参数的机器学习模型实现了AUC-ROC为0.78的整体生存预测.
结论:
- 纵向PRO数据,特别是LCSS动态,在NSCLC中提供了显著的预后价值.
- 这些发现支持将PRO动态纳入临床决策,以优化以患者为中心的治疗策略.
- 这种方法可以从患者的角度更好地了解疾病进展和治疗反应.
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