Length of stay (LOS) is an essential metric for the quality of hospital care. Published works on LOS analysis have primarily focused on skewed LOS distributions and the influences of patient diagnostic characteristics. Few authors have considered the events that terminate a hospital stay: Both successful discharge and death could end a hospital stay but with completely different implications. Modelling the time to the first occurrence of discharge or death obscures the true nature of LOS. In this research, we propose a structure that simultaneously models the probabilities of discharge and death. The model has a flexible formulation that accounts for both additive and multiplicative effects of factors influencing the occurrence of death and discharge. We present asymptotic properties of the parameter estimates so that valid inference can be performed for the parametric as well as nonparametric model components. Simulation studies confirmed the good finite-sample performance of the proposed method. As the research is motivated by practical issues encountered in LOS analysis, we analysed data from two real clinical studies to showcase the general applicability of the proposed model.
{"title":"Semi-parametric time-to-event modelling of lengths of hospital stays","authors":"Yang Li, Hao Liu, Xiaoshen Wang, Wanzhu Tu","doi":"10.1111/rssc.12593","DOIUrl":"10.1111/rssc.12593","url":null,"abstract":"<p>Length of stay (LOS) is an essential metric for the quality of hospital care. Published works on LOS analysis have primarily focused on skewed LOS distributions and the influences of patient diagnostic characteristics. Few authors have considered the events that terminate a hospital stay: Both successful discharge and death could end a hospital stay but with completely different implications. Modelling the time to the first occurrence of discharge or death obscures the true nature of LOS. In this research, we propose a structure that simultaneously models the probabilities of discharge and death. The model has a flexible formulation that accounts for both additive and multiplicative effects of factors influencing the occurrence of death and discharge. We present asymptotic properties of the parameter estimates so that valid inference can be performed for the parametric as well as nonparametric model components. Simulation studies confirmed the good finite-sample performance of the proposed method. As the research is motivated by practical issues encountered in LOS analysis, we analysed data from two real clinical studies to showcase the general applicability of the proposed model.</p>","PeriodicalId":49981,"journal":{"name":"Journal of the Royal Statistical Society Series C-Applied Statistics","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/b9/RSSC-71-1623.PMC9826400.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10525190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"数学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juhee Lee, Peter F. Thall, Bora Lim, Pavlos Msaouel
A Bayesian method is proposed for personalized treatment selection in settings where data are available from a randomized clinical trial with two or more outcomes. The motivating application is a randomized trial that compared letrozole plus bevacizumab to letrozole alone as first-line therapy for hormone receptor-positive advanced breast cancer. The combination treatment arm had larger median progression-free survival time, but also a higher rate of severe toxicities. This suggests that the risk-benefit trade-off between these two outcomes should play a central role in selecting each patient's treatment, particularly since older patients are less likely to tolerate severe toxicities. To quantify the desirability of each possible outcome combination for an individual patient, we elicited from breast cancer oncologists a utility function that varied with age. The utility was used as an explicit criterion for quantifying risk-benefit trade-offs when making personalized treatment selections. A Bayesian nonparametric multivariate regression model with a dependent Dirichlet process prior was fit to the trial data. Under the fitted model, a new patient's treatment can be selected based on the posterior predictive utility distribution. For the breast cancer trial dataset, the optimal treatment depends on the patient's age, with the combination preferable for patients 70 years or younger and the single agent preferable for patients older than 70.
{"title":"Utility-based Bayesian personalized treatment selection for advanced breast cancer","authors":"Juhee Lee, Peter F. Thall, Bora Lim, Pavlos Msaouel","doi":"10.1111/rssc.12582","DOIUrl":"10.1111/rssc.12582","url":null,"abstract":"<p>A Bayesian method is proposed for personalized treatment selection in settings where data are available from a randomized clinical trial with two or more outcomes. The motivating application is a randomized trial that compared letrozole plus bevacizumab to letrozole alone as first-line therapy for hormone receptor-positive advanced breast cancer. The combination treatment arm had larger median progression-free survival time, but also a higher rate of severe toxicities. This suggests that the risk-benefit trade-off between these two outcomes should play a central role in selecting each patient's treatment, particularly since older patients are less likely to tolerate severe toxicities. To quantify the desirability of each possible outcome combination for an individual patient, we elicited from breast cancer oncologists a utility function that varied with age. The utility was used as an explicit criterion for quantifying risk-benefit trade-offs when making personalized treatment selections. A Bayesian nonparametric multivariate regression model with a dependent Dirichlet process prior was fit to the trial data. Under the fitted model, a new patient's treatment can be selected based on the posterior predictive utility distribution. For the breast cancer trial dataset, the optimal treatment depends on the patient's age, with the combination preferable for patients 70 years or younger and the single agent preferable for patients older than 70.</p>","PeriodicalId":49981,"journal":{"name":"Journal of the Royal Statistical Society Series C-Applied Statistics","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10116488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"数学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In a bag-of-words model, the senses of a word with multiple meanings, for example ‘bank’ (used either in a river-bank or an institution sense), are represented as probability distributions over context words, and sense prevalence is represented as a probability distribution over senses. Both of these may change with time. Modelling and measuring this kind of sense change are challenging due to the typically high-dimensional parameter space and sparse datasets. A recently published corpus of ancient Greek texts contains expert-annotated sense labels for selected target words. Automatic sense-annotation for the word ‘kosmos’ (meaning decoration, order or world) has been used as a test case in recent work with related generative models and Monte Carlo methods. We adapt an existing generative sense change model to develop a simpler model for the main effects of sense and time, and give Markov Chain Monte Carlo methods for Bayesian inference on all these models that are more efficient than existing methods. We carry out automatic sense-annotation of snippets containing ‘kosmos’ using our model, and measure the time-evolution of its three senses and their prevalence. As far as we are aware, ours is the first analysis of this data, within the class of generative models we consider, that quantifies uncertainty and returns credible sets for evolving sense prevalence in good agreement with those given by expert annotation.
{"title":"Measuring diachronic sense change: New models and Monte Carlo methods for Bayesian inference","authors":"Schyan Zafar, Geoff K. Nicholls","doi":"10.1111/rssc.12591","DOIUrl":"10.1111/rssc.12591","url":null,"abstract":"<p>In a bag-of-words model, the <i>senses</i> of a word with multiple meanings, for example ‘bank’ (used either in a river-bank or an institution sense), are represented as probability distributions over context words, and sense prevalence is represented as a probability distribution over senses. Both of these may change with time. Modelling and measuring this kind of sense change are challenging due to the typically high-dimensional parameter space and sparse datasets. A recently published corpus of ancient Greek texts contains expert-annotated sense labels for selected target words. Automatic sense-annotation for the word ‘kosmos’ (meaning decoration, order or world) has been used as a test case in recent work with related generative models and Monte Carlo methods. We adapt an existing generative sense change model to develop a simpler model for the main effects of sense and time, and give Markov Chain Monte Carlo methods for Bayesian inference on all these models that are more efficient than existing methods. We carry out automatic sense-annotation of snippets containing ‘kosmos’ using our model, and measure the time-evolution of its three senses and their prevalence. As far as we are aware, ours is the first analysis of this data, within the class of generative models we consider, that quantifies uncertainty and returns credible sets for evolving sense prevalence in good agreement with those given by expert annotation.</p>","PeriodicalId":49981,"journal":{"name":"Journal of the Royal Statistical Society Series C-Applied Statistics","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://rss.onlinelibrary.wiley.com/doi/epdf/10.1111/rssc.12591","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82774142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"数学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Environmental Engel curves describe how households' income relates to the pollution associated with the services and goods consumed. This paper estimates these curves with neural networks using the novel dataset constructed in Levinson and O'Brien. We provide further statistical rigor to the empirical analysis by constructing prediction intervals obtained from novel neural network methods such as extra-neural nets and MC dropout. The application of these techniques for five different pollutants allow us to confirm statistically that Environmental Engel curves are upward sloping, have income elasticities smaller than one and shift down, becoming more concave, over time. Importantly, for the last year of the sample, we find an inverted U shape that suggests the existence of a maximum in pollution for medium-to-high levels of household income beyond which pollution flattens or decreases for top income earners.
{"title":"Environmental Engel curves: A neural network approach","authors":"Tullio Mancini, Hector Calvo-Pardo, Jose Olmo","doi":"10.1111/rssc.12588","DOIUrl":"10.1111/rssc.12588","url":null,"abstract":"<p>Environmental Engel curves describe how households' income relates to the pollution associated with the services and goods consumed. This paper estimates these curves with neural networks using the novel dataset constructed in Levinson and O'Brien. We provide further statistical rigor to the empirical analysis by constructing prediction intervals obtained from novel neural network methods such as extra-neural nets and MC dropout. The application of these techniques for five different pollutants allow us to confirm statistically that Environmental Engel curves are upward sloping, have income elasticities smaller than one and shift down, becoming more concave, over time. Importantly, for the last year of the sample, we find an inverted U shape that suggests the existence of a maximum in pollution for medium-to-high levels of household income beyond which pollution flattens or decreases for top income earners.</p>","PeriodicalId":49981,"journal":{"name":"Journal of the Royal Statistical Society Series C-Applied Statistics","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://rss.onlinelibrary.wiley.com/doi/epdf/10.1111/rssc.12588","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77934299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"数学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daewon Yang, Taeryon Choi, Eric Lavigne, Yeonseung Chung
Air pollution is a major threat to public health. Understanding the spatial distribution of air pollution concentration is of great interest to government or local authorities, as it informs about target areas for implementing policies for air quality management. Cluster analysis has been popularly used to identify groups of locations with similar profiles of average levels of multiple air pollutants, efficiently summarising the spatial pattern. This study aimed to cluster locations based on the seasonal patterns of multiple air pollutants incorporating the location-specific characteristics such as socio-economic indicators. For this purpose, we proposed a novel non-parametric Bayesian sparse latent factor model for covariate-dependent multivariate functional clustering. Furthermore, we extend this model to conduct clustering with temporal dependency. The proposed methods are illustrated through a simulation study and applied to time-series data for daily mean concentrations of ozone (