Bayesian

贝叶斯
  • 文章类型: Journal Article
    基因组评估过程依赖于基因组水平的密集单核苷酸多态性(SNP)标记与数量性状基因座(QTL)之间的连锁不平衡假设。本研究的目的是评估四种频率方法,包括岭回归,最小绝对收缩和选择算子(LASSO),ElasticNet,基因组最佳线性无偏预测(GBLUP)和包括贝叶斯岭回归(BRR)在内的五种贝叶斯方法,贝叶斯A,贝叶斯LASSO,贝叶斯C,和贝叶斯B,在使用模拟数据的基因组选择中。基于统计显著性(p值)成对评估预测准确性之间的差异(即,t检验和Mann-WhitneyU检验)和实际意义(科恩的d效应大小)为此,数据是基于两种不同标记密度(整个基因组中的4000和8000)的情景进行模拟的。模拟数据包括一个有四个染色体的基因组,每个1摩根,其中100个随机分布的QTL和两个不同密度的均匀分布的SNP(1000和2000),在0.4的遗传力水平,被认为。对于除GBLUP外的频率论方法,正则化参数λ是使用五折交叉验证方法计算的。对于这两种情况,在频率论方法中,通过岭回归和GBLUP观察到最高的预测准确性。岭回归和GBLUP显示了最低和最高的偏差,分别。此外,在贝叶斯方法中,BayesB和BRR显示出最高和最低的预测精度,分别。贝叶斯LASSO记录了两种情况下的最低偏差,第一种和第二种情况下的最高偏差由BRR和贝叶斯B显示,分别。在这两种情况下的所有研究方法中,BayesB、LASSO和ElasticNet显示了最高和最低的精度,分别。不出所料,在GBLUP和BRR之间观察到最大的性能相似性(d=0.007,在第一种情况下,d=0.003,在第二种情况下)。从参数t和非参数Mann-WhitneyU检验获得的结果相似。在第一种和第二种情况下,在每个场景中所研究方法的性能之间进行36t检验,14(P<。001)和2(P<。05)比较显著,分别,这表明随着预测因子数量的增加,不同方法的性能差异减小。这是根据科恩的d效应大小证明的,因此,随着模型复杂性的增加,效应大小并没有被视为非常大。在将这些方法用于基因组评估之前,应通过交叉验证方法优化频率方法中的正则化参数。
    The genomic evaluation process relies on the assumption of linkage disequilibrium between dense single-nucleotide polymorphism (SNP) markers at the genome level and quantitative trait loci (QTL). The present study was conducted with the aim of evaluating four frequentist methods including Ridge Regression, Least Absolute Shrinkage and Selection Operator (LASSO), Elastic Net, and Genomic Best Linear Unbiased Prediction (GBLUP) and five Bayesian methods including Bayes Ridge Regression (BRR), Bayes A, Bayesian LASSO, Bayes C, and Bayes B, in genomic selection using simulation data. The difference between prediction accuracy was assessed in pairs based on statistical significance (p-value) (i.e., t test and Mann-Whitney U test) and practical significance (Cohen\'s d effect size) For this purpose, the data were simulated based on two scenarios in different marker densities (4000 and 8000, in the whole genome). The simulated data included a genome with four chromosomes, 1 Morgan each, on which 100 randomly distributed QTL and two different densities of evenly distributed SNPs (1000 and 2000), at the heritability level of 0.4, was considered. For the frequentist methods except for GBLUP, the regularization parameter λ was calculated using a five-fold cross-validation approach. For both scenarios, among the frequentist methods, the highest prediction accuracy was observed by Ridge Regression and GBLUP. The lowest and the highest bias were shown by Ridge Regression and GBLUP, respectively. Also, among the Bayesian methods, Bayes B and BRR showed the highest and lowest prediction accuracy, respectively. The lowest bias in both scenarios was registered by Bayesian LASSO and the highest bias in the first and the second scenario were shown by BRR and Bayes B, respectively. Across all the studied methods in both scenarios, the highest and the lowest accuracy were shown by Bayes B and LASSO and Elastic Net, respectively. As expected, the greatest similarity in performance was observed between GBLUP and BRR ( d = 0.007 , in the first scenario and d = 0.003 , in the second scenario). The results obtained from parametric t and non-parametric Mann-Whitney U tests were similar. In the first and second scenario, out of 36 t test between the performance of the studied methods in each scenario, 14 ( P < . 001 ) and 2 ( P < . 05 ) comparisons were significant, respectively, which indicates that with the increase in the number of predictors, the difference in the performance of different methods decreases. This was proven based on the Cohen\'s d effect size, so that with the increase in the complexity of the model, the effect size was not seen as very large. The regularization parameters in frequentist methods should be optimized by cross-validation approach before using these methods in genomic evaluation.
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  • 文章类型: Journal Article
    目的:比较耐甲氧西林金黄色葡萄球菌(MRSA)感染的危重患者的两种万古霉素给药策略,考虑给药方案的异质性及其对毒性和疗效的影响.材料与方法:在两个患者队列中的纵向回顾性观察研究(标准给药与通过贝叶斯算法给药)。结果:贝叶斯算法组接受了更高和显著异质的剂量,没有肾毒性。对于贝叶斯策略,CRP和PCT的下降速度更大(分别为p=0.045和0.0009)。结论:将贝叶斯算法应用于万古霉素剂量个体化允许施用比标准方案高得多的剂量,在没有肾毒性的情况下促进更快的临床反应。
    [方框:见正文]。
    Aim: Compare two vancomycin dosing strategies in critical patients with methicillin-resistant Staphylococcus aureus (MRSA) infections, considering the heterogeneity of the dosing regimens administered and their implications for toxicity and efficacy. Materials & methods: Longitudinal retrospective observational study in two patient cohorts (standard dosing vs dosing via Bayesian algorithms). Results: The group of Bayesian algorithms received substantially higher and significantly heterogeneous doses, with an absence of nephrotoxicity. The speed of decrease observed in CRP and PCT was greater for the Bayesian strategy (p = 0.045 and 0.0009, respectively). Conclusion: Applying Bayesian algorithms to vancomycin dosage individualization allows for administering much higher doses than with standard regimens, facilitating a quicker clinical response in the absence of nephrotoxicity.
    [Box: see text].
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  • 文章类型: Journal Article
    分层预测处理提供了一个框架,概述了先前的期望如何塑造感知和认知。这里,我们强调分层预测处理作为解释社会背景和基于群体的社会知识如何直接塑造群体间感知的框架。更具体地说,我们认为,分层预测处理赋予了一个独特的有价值的工具集来解释现有的发现,并为群体间的感知产生新的假设。我们首先提供分层预测处理的概述,具体说明其主要理论假设。然后,我们回顾了显示先验知识如何影响群体间感知的证据。接下来,我们概述了分层预测处理如何很好地解释群体间感知文献中的发现。然后,与该领域的其他框架相比,我们强调了分层预测处理的理论优势。最后,我们概述了未来的方向,并提出了假设,以更广泛地测试分层预测处理对群体间感知和群体间认知的影响。一起来看,分层预测处理为群体间感知的新假设生成提供了解释价值和能力。
    Hierarchical predictive processing provides a framework outlining how prior expectations shape perception and cognition. Here, we highlight hierarchical predictive processing as a framework for explaining how social context and group-based social knowledge can directly shape intergroup perception. More specifically, we argue that hierarchical predictive processing confers a uniquely valuable toolset to explain extant findings and generate novel hypotheses for intergroup perception. We first provide an overview of hierarchical predictive processing, specifying its primary theoretical assumptions. We then review evidence showing how prior knowledge influences intergroup perception. Next, we outline how hierarchical predictive processing can account well for findings in the intergroup perception literature. We then underscore the theoretical strengths of hierarchical predictive processing compared to other frameworks in this space. We finish by outlining future directions and laying out hypotheses that test the implications of hierarchical predictive processing for intergroup perception and intergroup cognition more broadly. Taken together, hierarchical predictive processing provides explanatory value and capacity for novel hypothesis generation for intergroup perception.
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  • 文章类型: Journal Article
    背景:尽管免疫检查点抑制剂(ICIs)为非小细胞肺癌(NSCLC)带来了生存益处,疾病进展仍在发生,对于这些患者的治疗方案没有达成共识。我们设计了一个网络荟萃分析(NMA)来评估ICIs失败后NSCLC的全身治疗方案。
    方法:PubMed,Embase,搜索了WebofScience和CochraneLibrary数据库,然后进行文献筛选,然后进行NMA。我们纳入了所有II期和III期随机对照试验(RCTs)。无进展生存期(PFS)和总生存期(OS)使用风险比(HR)进行评估。客观反应率(ORR)和不良事件(AE)使用比值比(OR)和相对风险(RR)效应大小,分别。应用R软件比较贝叶斯NMA结果。
    结果:我们最终纳入了6项研究。1322例患者接受ICI加化疗(ICI+化疗),ICI加抗血管生成单克隆抗体(ICI+抗血管抗体),ICI加酪氨酸激酶抑制剂(ICI+TKI),酪氨酸激酶抑制剂加化疗(TKI+化疗),护理标准(SOC)化疗(化疗)。TKI+化疗与较长的PFS相关,较高的ORR(累积排序曲线下的曲面[SUCRA],99.7%,88.2%),ICI+TKI实现了最长的操作系统(SUCRA,82.7%)。ICI+Antiangio-Ab被授予任何级别的不良事件(AE)的最高安全评级,大于或等于3级的不良事件以及导致停止治疗的任何等级的不良事件(SUCRA,95%,82%,93%)。
    结论:对于ICIs失败后的非小细胞肺癌,TKI+化疗与较长的PFS和较高的ORR相关,而ICI+TKI与最长的操作系统相关。在安全方面,ICI+Antiangio-Ab最高。
    BACKGROUND: Although immune checkpoint inhibitors (ICIs) have brought survival benefits to non-small cell lung cancer (NSCLC), disease progression still occurs, and there is no consensus on the treatment options for these patients. We designed a network meta-analysis (NMA) to evaluate systemic treatment options for NSCLC after failure of ICIs.
    METHODS: PubMed, Embase, Web of Science and Cochrane Library databases were searched, then literature screening was followed by NMA. We included all Phase II and III randomized controlled trials (RCTs). Progression-free survival (PFS) and overall survival (OS) used hazard ratio (HR) for evaluation. Objective response rate (ORR) and adverse events (AEs) used odds ratio (OR) and relative risk (RR) effect sizes, respectively. R software was applied to compare the Bayesian NMA results.
    RESULTS: We finally included 6 studies. 1322 patients received ICI plus Chemotherapy (ICI + Chemo), ICI plus Anti-angiogenic monoclonal antibody (ICI + Antiangio-Ab), ICI plus Tyrosine kinase inhibitor (ICI + TKI), Tyrosine kinase inhibitor plus Chemotherapy (TKI + Chemo), Standard of Care (SOC), Chemotherapy (Chemo). TKI + Chemo is associated with longer PFS, higher ORR (surface under cumulative ranking curve [SUCRA], 99.7%, 88.2%), ICI + TKI achieved the longest OS (SUCRA, 82.7%). ICI + Antiangio-Ab was granted the highest safety rating for adverse events (AEs) of any grade, AEs greater than or equal to grade 3 and AEs of any grade leading to discontinuation of treatment (SUCRA, 95%, 82%, 93%).
    CONCLUSIONS: For NSCLC after failure of ICIs, TKI + Chemo was associated with longer PFS and higher ORR, while ICI + TKI was associated with the longest OS. In terms of safety, ICI + Antiangio-Ab was the highest.
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  • 文章类型: Journal Article
    随着时间的推移,已经研究了孕产妇死亡率(MMR)估计值,以了解其在全国范围内的变化。然而,如果不考虑空间上的可变性,这是不够的,时间,孕产妇和系统水平因素。该研究努力估计和量化暴露的影响,包括所有孕产妇健康指标和系统水平指标以及影响印度MMR的时空影响。使用MMR的可能因素的最新水平,来自全国家庭健康调查(NFHS:2019-21)的孕产妇健康指标和来自政府报告热图的系统级指标比较了所有19个SRS州的相对表现.具有回归线的刻面图用于研究一个帧中不同状态的MMR模式。利用贝叶斯时空随机效应,使用来自SRS报告(2014-2020)的MMR估计值,得出了各个州之间不同MMR模式和空间风险量化的证据.印度见证了MMR的下降,对于大多数州来说,这个下降是线性的。很少州表现出周期性趋势,例如哈里亚纳邦和西孟加拉邦的增长趋势,这从两个分析模型中可以看出,即,刻面图和贝叶斯时空模型。所有州共有的MMR水平的主要过渡期被确定为2009-2013年。Bihar和Assam估计了空间风险的后验概率,相对于其他SRS状态,并被归类为热点。超过个人层面的因素,卫生系统因素导致MMR降低幅度更大。为了获得更可靠的调查结果,需要地区水平的可靠估计。从我们的研究中可以明显看出,在印度,降低MMR的两个最强大的卫生系统影响因素是机构分娩和熟练的接生。
    Maternal mortality ratio (MMR) estimates have been studied over time for understanding its variation across the country. However, it is never sufficient without accounting for presence of variability across in terms of space, time, maternal and system level factors. The study endeavours to estimate and quantify the effect of exposures encompassing all maternal health indicators and system level indicators along with space-time effects influencing MMR in India. Using the most recent level of possible -factors of MMR, maternal health indicators from the National Family Health Survey (NFHS: 2019-21) and system level indicators from government reports a heatmap compared the relative performance of all 19 SRS states. Facet plots with a regression line was utilised for studying patterns of MMR for different states in one frame. Using Bayesian Spatio-temporal random effects, evidence for different MMR patterns and quantification of spatial risks among individual states was produced using estimates of MMR from SRS reports (2014-2020). India has witnessed a decline in MMR, and for the majority of the states, this drop is linear. Few states exhibit cyclical trend such as increasing trends for Haryana and West Bengal which was evident from the two analytical models i.e., facet plots and Bayesian spatio- temporal model. Period of major transition in MMR levels which was common to all states is identified as 2009-2013. Bihar and Assam have estimated posterior probabilities for spatial risk that are relatively greater than other SRS states and are classified as hot spots. More than the individual level factors, health system factors account for a greater reduction in MMR. For more robust findings district level reliable estimates are required. As evident from our study the two most strong health system influencers for reducing MMR in India are Institutional delivery and Skilled birth attendance.
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  • 文章类型: Journal Article
    在认知神经科学和神经心理学文献中,观察到阅读的神经相关性是左侧化的。尽管如此,阅读是由一组神经单元服务的,这些单位在多大程度上始终处于左倾状态尚不清楚。在这方面,梭状回的功能偏侧化特别令人感兴趣,凭借其作为“视觉单词形式区域”的假设作用。对35个研究沉默阅读的实验的激活灶进行了定量激活似然估计荟萃分析,全脑和基于贝叶斯ROI的方法均用于评估提交给荟萃分析的数据的偏侧化。Perirolandic地区显示出最高水平的左侧化,梭形皮层和顶叶皮层仅表现出中等程度的左偏向模式,在枕骨时,岛状皮层和小脑中的侧向化是观察到的最低。在对每项研究的偏侧化概况的回归分析中,进一步探讨了梭状回相对有限的功能偏侧化。阅读过程中梭形回的功能偏侧化与中央前回和枕下回的偏侧化呈正相关,而与额下回和颞极的三角形部分的偏侧化呈负相关。总的来说,目前的数据突出了阅读网络中的偏侧化模式是如何不同的。此外,目前的数据强调了阅读过程中梭状回的功能偏侧化与其他语言大脑区域的功能偏侧化程度的关系。
    The observation that the neural correlates of reading are left-lateralized is ubiquitous in the cognitive neuroscience and neuropsychological literature. Still, reading is served by a constellation of neural units, and the extent to which these units are consistently left-lateralized is unclear. In this regard, the functional lateralization of the fusiform gyrus is of particular interest, by virtue of its hypothesized role as a \"visual word form area\". A quantitative Activation Likelihood Estimation meta-analysis was conducted on activation foci from 35 experiments investigating silent reading, and both a whole-brain and a bayesian ROI-based approach were used to assess the lateralization of the data submitted to meta-analysis. Perirolandic areas showed the highest level of left-lateralization, the fusiform cortex and the parietal cortex exhibited only a moderate pattern of left-lateralization, while in the occipital, insular cortices and in the cerebellum the lateralization turned out to be the lowest observed. The relatively limited functional lateralization of the fusiform gyrus was further explored in a regression analysis on the lateralization profile of each study. The functional lateralization of the fusiform gyrus during reading was positively associated with the lateralization of the precentral and inferior occipital gyri and negatively associated with the lateralization of the triangular portion of the inferior frontal gyrus and of the temporal pole. Overall, the present data highlight how lateralization patterns differ within the reading network. Furthermore, the present data highlight how the functional lateralization of the fusiform gyrus during reading is related to the degree of functional lateralization of other language brain areas.
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  • 文章类型: Journal Article
    极端边缘的机器学习实现了大量的智能,时间紧迫,和远程应用程序。然而,部署可解释的人工智能系统,可以执行高级符号推理,并满足底层的系统规则和物理在紧张的平台资源限制是具有挑战性的。在本文中,我们介绍TinyNS,第一个平台感知神经符号架构搜索框架,用于符号和神经算子的联合优化。TinyNS提供配方和解析器,以自动为五种类型的神经符号模型编写微控制器代码,将符号技术的上下文感知和完整性与机器学习模型的鲁棒性和性能相结合。TinyNS使用快速,无梯度,不连续的黑盒贝叶斯优化器,有条件的,数值,和分类搜索空间,以在硬件资源预算内找到符号代码和神经网络的最佳协同作用。为了保证可部署性,TinyNS在优化过程中与目标硬件进行对话。我们通过几个案例研究部署微控制器类神经符号模型来展示TinyNS的实用性。在所有用例中,TinyNS优于纯神经或纯符号方法,同时保证在实际硬件上执行。
    Machine learning at the extreme edge has enabled a plethora of intelligent, time-critical, and remote applications. However, deploying interpretable artificial intelligence systems that can perform high-level symbolic reasoning and satisfy the underlying system rules and physics within the tight platform resource constraints is challenging. In this paper, we introduce TinyNS, the first platform-aware neurosymbolic architecture search framework for joint optimization of symbolic and neural operators. TinyNS provides recipes and parsers to automatically write microcontroller code for five types of neurosymbolic models, combining the context awareness and integrity of symbolic techniques with the robustness and performance of machine learning models. TinyNS uses a fast, gradient-free, black-box Bayesian optimizer over discontinuous, conditional, numeric, and categorical search spaces to find the best synergy of symbolic code and neural networks within the hardware resource budget. To guarantee deployability, TinyNS talks to the target hardware during the optimization process. We showcase the utility of TinyNS by deploying microcontroller-class neurosymbolic models through several case studies. In all use cases, TinyNS outperforms purely neural or purely symbolic approaches while guaranteeing execution on real hardware.
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  • 文章类型: Journal Article
    背景/目标:虽然美国的婴儿死亡率在过去几十年中一直在下降,种族差异,定义为种族之间的差异,增加了。即使一个人的种族无法改变,也许可以找出调解或导致这种种族差异的因素。必须评估调解或导致种族差异的因素,因为当前的临床建议可能基于对白人妇女及其子女更有效的预防方式。方法:贝叶斯方法对2016年至2018年美国国家自然数据库中的数据进行建模。种族和中介的每个组合的二项式率参数提供了潜在的结果。估计调解结果,包括总效应,受控的直接效应,介导效应,和比例中介对这些概率使用了共同的反事实定义。结果:母亲吸烟,低出生体重,和少女产妇相互作用,导致婴儿死亡率的种族差异。归因于低出生体重的种族差异比例约为0.73,仅归因于母亲吸烟和少女生育。结论:新方法促进了多种介体的建模。低出生体重导致婴儿死亡率的种族差异。该模型可以扩展到评估其他中介因素,以确定可预防的原因。
    Background/Objectives: While the overall rate of infant mortality in the United States has been decreasing over decades, the racial disparity, defined as the difference between races, has increased. Even though a person\'s race cannot change, it may be possible to identify factors that mediate or cause this racial disparity. Evaluating the factors that mediate or cause racial disparity is imperative because current clinical recommendations could be based on preventative modalities that are more effective for white women and their children. Methods: A Bayesian approach modeled the data from the full United States National Natality Database for the years 2016 to 2018. The binomial rate parameters for each combination of race and mediators provided the potential outcomes. Estimating the mediation outcomes, including total effect, controlled direct effect, mediated effect, and proportion mediated used common counterfactual definitions for these probabilities. Results: Maternal smoking, low birthweight, and teenage maternity interacted in causing racial disparity for infant mortality. The proportion of racial disparity attributable to low birthweight was approximately 0.73, with only small variations attributable to maternal smoking and teenage maternity. Conclusions: The novel approach facilitated modeling of multiple mediators. Low birthweight caused racial disparity for infant mortality. The model can be extended to evaluate additional mediational factors with the objective of identifying the preventable causes.
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  • 文章类型: Journal Article
    亚组分析可用于调查由基线特征定义的研究人群的亚组之间的治疗效果异质性。近年来已经提出了几种方法,统计问题,如多重性,复杂性,选择偏差已经被广泛讨论。一些方法针对这些问题中的一个或多个进行调整;然而,他们中很少有人讨论或考虑子组分配的稳定性。我们建议探索亚组的稳定性,作为分层医学的敏感性分析步骤,除了确定可能导致这种不稳定性的可能因素外,还可以评估所识别亚组的稳健性。在应用贝叶斯可信子群后,非参数引导可用于评估亚组水平和患者水平的稳定性.我们的研究结果表明,当治疗效果很小或不那么明显时,患者更有可能通过引导再采样切换到不同的亚组(跳线).相比之下,当治疗效果很大或极具说服力时,患者通常保留在同一亚组。虽然所提出的子群稳定性方法通过贝叶斯可信子群方法在时间到事件数据上进行了说明,这种通用方法可以与其他子组识别方法和端点一起使用。
    Subgroup analysis may be used to investigate treatment effect heterogeneity among subsets of the study population defined by baseline characteristics. Several methodologies have been proposed in recent years and with these, statistical issues such as multiplicity, complexity, and selection bias have been widely discussed. Some methods adjust for one or more of these issues; however, few of them discuss or consider the stability of the subgroup assignments. We propose exploring the stability of subgroups as a sensitivity analysis step for stratified medicine to assess the robustness of the identified subgroups besides identifying possible factors that may drive this instability. After applying Bayesian credible subgroups, a nonparametric bootstrap can be used to assess stability at subgroup-level and patient-level. Our findings illustrate that when the treatment effect is small or not so evident, patients are more likely to switch to different subgroups (jumpers) across bootstrap resamples. In contrast, when the treatment effect is large or extremely convincing, patients generally remain in the same subgroup. While the proposed subgroup stability method is illustrated through Bayesian credible subgroups method on time-to-event data, this general approach can be used with other subgroup identification methods and endpoints.
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  • 文章类型: Journal Article
    背景:在全球范围内,前列腺癌是男性癌症死亡的第二大原因。它是澳大利亚最常见的癌症。由于疾病本身及其相关并发症,与普通人群相比,前列腺癌患者的生活质量较差。然而,关于维多利亚州生活质量的地理格局及其危险因素的研究有限。因此,对生活质量差的时空模式和危险因素的检查,以及空间权重矩阵对估计和模型性能的影响,进行了。
    方法:根据维多利亚前列腺癌结果登记数据进行回顾性研究。患者数据(n=5238)从前列腺癌结果注册表中提取,2015年至2021年基于人群的临床质量结果评估。采用贝叶斯时空多水平模型来识别生活质量差的危险因素。本研究还评估了基于距离和邻接的空间权重矩阵的影响。使用Gelman-Rubin统计图评估模型收敛性,模型比较基于渡边-Akaike信息标准。
    结果:在我们的研究中,共有1906例(36.38%)接受手术的前列腺癌患者经历了较差的生活质量。属于76至85岁之间的年龄组(调整后的优势比(AOR)=2.90,95%可信区间(CrI):1.39,2.08),前列腺特异性抗原水平在10.1和20.0之间(AOR=1.33,95%CrI:1.12,1.58),在公立医院接受治疗(AOR=1.35,95%CrI:1.17,1.53)与较高的生活质量差几率显著相关.相反,居住在高度可接近区域(AOR=0.60,95%CrI:0.38,0.94)与前列腺特异性抗原水平低的几率显著相关.根据空间权重矩阵的选择,可以观察到估计值和模型性能的变化。
    结论:属于年龄较大的人群,具有较高的前列腺特异性抗原水平,在公立医院接受治疗,和偏远是与生活质量差相关的统计学显著因素。在维多利亚州各地方政府地区观察到生活质量差的时空变化。基于距离的权重矩阵比基于邻接的矩阵表现得更好。这项研究发现强调了减少生活质量地理差异的必要性。本研究中开发的统计方法也可能适用于其他基于人群的临床注册设置。
    BACKGROUND: Globally, prostate cancer is the second leading cause of cancer deaths among males. It is the most commonly diagnosed cancer in Australia. The quality of life of prostate cancer patients is poorer when compared to the general population due to the disease itself and its related complications. However, there is limited research on the geographic pattern of quality of life and its risk factors in Victoria. Therefore, an examination of the spatio-temporal pattern and risk factors of poor quality of life, along with the impact of spatial weight matrices on estimates and model performance, was conducted.
    METHODS: A retrospective study was undertaken based on the Prostate Cancer Outcome Registry-Victoria data. Patient data (n = 5238) were extracted from the Prostate Cancer Outcome Registry, a population-based clinical quality outcome assessment from 2015 to 2021. A Bayesian spatio-temporal multilevel model was fitted to identify risk factors for poor quality of life. This study also evaluated the impact of distance- and adjacency-based spatial weight matrices. Model convergence was assessed using Gelman-Rubin statistical plots, and model comparison was based on the Watanabe-Akaike Information Criterion.
    RESULTS: A total of 1906 (36.38%) prostate cancer patients who had undergone surgery experienced poor quality of life in our study. Belonging to the age group between 76 and 85 years (adjusted odds ratio (AOR) = 2.90, 95% credible interval (CrI): 1.39, 2.08), having a prostate-specific antigen level between 10.1 and 20.0 (AOR = 1.33, 95% CrI: 1.12, 1.58), and being treated in a public hospital (AOR = 1.35, 95% CrI: 1.17, 1.53) were significantly associated with higher odds of poor quality of life. Conversely, residing in highly accessible areas (AOR = 0.60, 95% CrI: 0.38, 0.94) was significantly associated with lower odds of poor prostate-specific antigen levels. Variations in estimates and model performance were observed depending on the choice of spatial weight matrices.
    CONCLUSIONS: Belonging to an older age group, having a high prostate-specific antigen level, receiving treatment in public hospitals, and remoteness were statistically significant factors linked to poor quality of life. Substantial spatio-temporal variations in poor quality of life were observed in Victoria across local government areas. The distance-based weight matrix performed better than the adjacency-based matrix. This research finding highlights the need to reduce geographical disparities in quality of life. The statistical methods developed in this study may also be useful to apply to other population-based clinical registry settings.
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