Bayesian statistics

贝叶斯统计
  • 文章类型: Journal Article
    使用区域同质性(ReHo)分析的功能磁共振成像研究发现,与健康对照相比,患有轻度认知障碍(MCI)和阿尔茨海默病(AD)的个体的局部脑连通性异常。然而,精确定位,范围,和这些像差的可能重叠仍然没有完全理解。为了弥合这个差距,我们应用了一种新的元分析和贝叶斯方法(最小贝叶斯因子激活似然估计,mBF-ALE),用于系统探索MCI和AD大脑中的局部功能连接改变。我们通过标准化的MEDLINE数据库搜索提取ReHo数据,其中包括35个同行评审的实验,1,256名AD或MCI患者,1,118名健康对照,和205个ReHo变化的x-y-z坐标。然后,我们将数据分为两个不同的数据集:一个用于MCI,另一个用于AD。进行了两次mBF-ALE分析,阈值为“非常有力的证据”(mBF≥150),最小集群尺寸为200毫米。我们还使用ALE算法的规范版本评估了贝叶斯结果的空间一致性和敏感性。对于MCI,我们观察到两个簇的ReHo减少和一个ReHo增加。在左前肌(Brodmann区-BA7)和左颞下回(BA20),局部连通性明显下降,而右侧海马旁回的连通性明显增加(BA36)。规范的ALE确认了这些位置,除了颞下回.在AD中,发现ReHo每个减少和增加一个簇,右后扣带回皮质的连通性降低(BA30延伸至BA23),左后扣带回皮质的连通性增加(BA31)。这些位置已由规范的ALE确认。这些不同的功能连接模式的鉴定为MCI和AD的复杂病理生理学提供了新的思路。为未来基于神经影像学的干预提供了有希望的方向。此外,使用贝叶斯框架进行统计阈值提高了神经影像学荟萃分析的鲁棒性,扩大其对小数据集的适用性。
    Functional magnetic resonance imaging research employing regional homogeneity (ReHo) analysis has uncovered aberrant local brain connectivity in individuals with mild cognitive impairment (MCI) and Alzheimer\'s disease (AD) in comparison with healthy controls. However, the precise localization, extent, and possible overlap of these aberrations are still not fully understood. To bridge this gap, we applied a novel meta-analytic and Bayesian method (minimum Bayes Factor Activation Likelihood Estimation, mBF-ALE) for a systematic exploration of local functional connectivity alterations in MCI and AD brains. We extracted ReHo data via a standardized MEDLINE database search, which included 35 peer-reviewed experiments, 1,256 individuals with AD or MCI, 1,118 healthy controls, and 205 x-y-z coordinates of ReHo variation. We then separated the data into two distinct datasets: one for MCI and the other for AD. Two mBF-ALE analyses were conducted, thresholded at \"very strong evidence\" (mBF ≥ 150), with a minimum cluster size of 200 mm³. We also assessed the spatial consistency and sensitivity of our Bayesian results using the canonical version of the ALE algorithm. For MCI, we observed two clusters of ReHo decrease and one of ReHo increase. Decreased local connectivity was notable in the left precuneus (Brodmann area - BA 7) and left inferior temporal gyrus (BA 20), while increased connectivity was evident in the right parahippocampal gyrus (BA 36). The canonical ALE confirmed these locations, except for the inferior temporal gyrus. In AD, one cluster each of ReHo decrease and increase were found, with decreased connectivity in the right posterior cingulate cortex (BA 30 extending to BA 23) and increased connectivity in the left posterior cingulate cortex (BA 31). These locations were confirmed by the canonical ALE. The identification of these distinct functional connectivity patterns sheds new light on the complex pathophysiology of MCI and AD, offering promising directions for future neuroimaging-based interventions. Additionally, the use of a Bayesian framework for statistical thresholding enhances the robustness of neuroimaging meta-analyses, broadening its applicability to small datasets.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    时间到事件数据通常记录在一个离散的尺度上,具有多个,相互竞争的风险作为事件的潜在原因。在这种情况下,应用具有单一风险的连续生存分析方法存在估计偏差。因此,我们提出了多变量伯努利检测器,用于具有离散时间的竞争风险,其中涉及针对特定原因的基线风险的多变量变点模型.通过先验上的变化点的数量和它们的位置,我们在不同风险的变化点之间施加依赖性,以及允许数据驱动学习他们的数量。然后,有条件地在这些变化点上,多变量伯努利先验用于推断涉及哪些风险。后验推理的重点是特定于原因的危险率和跨风险的依赖性。这种依赖性通常是由于影响所有风险的特定受试者随时间的变化而存在的。完全后验推理是通过定制的局部-全局马尔可夫链蒙特卡罗(MCMC)算法执行的,它利用了数据增强技巧和来自非共轭贝叶斯非参数方法的MCMC更新。我们在模拟和ICU数据中说明了我们的模型,将其性能与现有方法进行比较。
    Time-to-event data are often recorded on a discrete scale with multiple, competing risks as potential causes for the event. In this context, application of continuous survival analysis methods with a single risk suffers from biased estimation. Therefore, we propose the multivariate Bernoulli detector for competing risks with discrete times involving a multivariate change point model on the cause-specific baseline hazards. Through the prior on the number of change points and their location, we impose dependence between change points across risks, as well as allowing for data-driven learning of their number. Then, conditionally on these change points, a multivariate Bernoulli prior is used to infer which risks are involved. Focus of posterior inference is cause-specific hazard rates and dependence across risks. Such dependence is often present due to subject-specific changes across time that affect all risks. Full posterior inference is performed through a tailored local-global Markov chain Monte Carlo (MCMC) algorithm, which exploits a data augmentation trick and MCMC updates from nonconjugate Bayesian nonparametric methods. We illustrate our model in simulations and on ICU data, comparing its performance with existing approaches.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    构建基因调控网络是研究基因调控的一种广泛采用的方法。在生物学和医学中提供多样化的应用。大量的研究集中在使用时间序列数据或单细胞RNA测序数据来推断基因调控网络。然而,这样的基因表达数据缺乏细胞或时间信息。幸运的是,延时共聚焦激光显微镜的出现使生物学家能够获得秀丽隐杆线虫的树形基因表达数据,实现细胞和时间分辨率。尽管这样的树形数据提供了丰富的知识,它们像非配对时间序列一样构成挑战,奠定了下游分析的不准确性。为了解决这个问题,提出了一个全面的数据集成框架和一种新的基于布尔时滞网络的贝叶斯方法。应用预筛选过程和马尔可夫链蒙特卡罗算法获得参数估计。仿真研究表明,我们的方法优于现有的布尔网络推理算法。利用拟议的方法,基于秀丽隐杆线虫的真实树形数据集,重建了五个子树的基因调控网络,在以前的遗传研究中证实的一些基因调控关系被恢复。此外,检测到不同细胞谱系子树中调节关系的异质性。此外,正在探索在人类疾病中具有重要意义的潜在基因调控关系。所有源代码均可在GitHub存储库https://github.com/edawu11/BBTD获取。git.
    Constructing gene regulatory networks is a widely adopted approach for investigating gene regulation, offering diverse applications in biology and medicine. A great deal of research focuses on using time series data or single-cell RNA-sequencing data to infer gene regulatory networks. However, such gene expression data lack either cellular or temporal information. Fortunately, the advent of time-lapse confocal laser microscopy enables biologists to obtain tree-shaped gene expression data of Caenorhabditis elegans, achieving both cellular and temporal resolution. Although such tree-shaped data provide abundant knowledge, they pose challenges like non-pairwise time series, laying the inaccuracy of downstream analysis. To address this issue, a comprehensive framework for data integration and a novel Bayesian approach based on Boolean network with time delay are proposed. The pre-screening process and Markov Chain Monte Carlo algorithm are applied to obtain the parameter estimates. Simulation studies show that our method outperforms existing Boolean network inference algorithms. Leveraging the proposed approach, gene regulatory networks for five subtrees are reconstructed based on the real tree-shaped datatsets of Caenorhabditis elegans, where some gene regulatory relationships confirmed in previous genetic studies are recovered. Also, heterogeneity of regulatory relationships in different cell lineage subtrees is detected. Furthermore, the exploration of potential gene regulatory relationships that bear importance in human diseases is undertaken. All source code is available at the GitHub repository https://github.com/edawu11/BBTD.git.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    大多数肿瘤学试验根据频率显著性阈值定义了实验治疗与对照治疗相比的优越性。被广泛误解。通过贝叶斯推断计算的后验概率分布可能是更直观的不确定性度量,特别是对于临床益处的测量,例如最小临床重要差异(MCID)。这里,我们手动重建了230个III期的194,129个患者水平的结果,优越性设计,肿瘤学试验。后验是通过使用标准先验的马尔可夫链蒙特卡罗抽样计算的。所有被解释为阳性的试验的边际效益概率>90%(HR<1)。然而,38%的阳性试验达到MCID的概率≤90%(HR<0.8),即使在热情的事先。对82项获得监管部门批准的试验进行的亚组分析显示,在热情的先验下,30%的人符合MCID的概率≤90%。相反,24%的阴性试验有>90%的概率实现边际效益,即使在怀疑之前,包括12项主要终点为总生存期的试验。最后,来自先前工作的III期肿瘤学特异性之前,它使用公布的汇总统计数据而不是重建的数据来计算后验,验证了个体患者水平的数据发现。一起来看,这些结果表明,贝叶斯模型为III期肿瘤学试验增加了相当独特的解释价值,并为克服驳斥零假设与获得MCID之间的差异提供了可靠的解决方案.
    结论:肿瘤学试验的统计分析通常通过计算P值来进行,虽然人们对这些知之甚少。使用P值截止值,如P<0.05,可能导致一些治疗被接受,没有什么好处,和其他疗法被拒绝,有相当大的好处。可以通过贝叶斯统计来计算更直观和直接的概率-实验性治疗优于标准治疗。在这里,我们使用软件获得了230项试验中纳入的194,129名患者的结果,然后计算受益概率。基于P值的解释与三分之一试验的获益概率不一致。这项研究表明,受益概率将大大提高肿瘤学试验的解释。
    Most oncology trials define superiority of an experimental therapy compared to a control therapy according to frequentist significance thresholds, which are widely misinterpreted. Posterior probability distributions computed by Bayesian inference may be more intuitive measures of uncertainty, particularly for measures of clinical benefit such as the minimum clinically important difference (MCID). Here, we manually reconstructed 194,129 individual patient-level outcomes across 230 phase III, superiority-design, oncology trials. Posteriors were calculated by Markov Chain Monte Carlo sampling using standard priors. All trials interpreted as positive had probabilities > 90% for marginal benefits (HR < 1). However, 38% of positive trials had ≤ 90% probabilities of achieving the MCID (HR < 0.8), even under an enthusiastic prior. A subgroup analysis of 82 trials that led to regulatory approval showed 30% had ≤ 90% probability for meeting the MCID under an enthusiastic prior. Conversely, 24% of negative trials had > 90% probability of achieving marginal benefits, even under a skeptical prior, including 12 trials with a primary endpoint of overall survival. Lastly, a phase III oncology-specific prior from a previous work, which uses published summary statistics rather than reconstructed data to compute posteriors, validated the individual patient-level data findings. Taken together, these results suggest that Bayesian models add considerable unique interpretative value to phase III oncology trials and provide a robust solution for overcoming the discrepancies between refuting the null hypothesis and obtaining a MCID.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    新的抗白血病疗法(抗CD20单克隆抗体,布鲁顿酪氨酸激酶抑制剂,磷酸肌醇3-激酶抑制剂,和B细胞淋巴瘤-2拮抗剂)在复发性/难治性慢性淋巴细胞白血病(CLL)患者的临床试验中,与选定的标准方案相比,改善了无进展生存期(PFS)。不幸的是,所有可能的治疗方案的相对疗效仍然未知,因为没有直接证据支持所有可能的比较.
    我们旨在比较新型药物的疗效和安全性,化疗,和免疫疗法使用贝叶斯网络荟萃分析(NMA)。
    使用贝叶斯NMA进行系统文献综述。
    对复发/难治性CLL的随机临床试验进行了广泛的系统文献综述。我们搜索了医学数据库中索引的文章(MEDLINE,Embase,Cochrane库)和灰色文献,可以进一步实施到贝叶斯NMA中。
    系统搜索确定了15项随机试验,这些试验形成了比较PFS的网络,总生存期(OS),总体反应率,和严重不良事件。我们的研究表明,与标准化学免疫疗法和免疫疗法相比,所有包含新型药物的方案均显着延长了PFS。在靶向药物中,维奈托克(VEN)+利妥昔单抗(RTX)在PFS方面的疗效与扎努鲁替尼(ZAN)相当[风险比(95%可信区间),1.10(0.59-2.08)],阿卡拉布替尼(ACA)[0.78(0.47-1.30)],依鲁替尼(IBR)单药治疗[0.72(0.41-1.27)],和其他基于IBR的方案。ZAN优于IBR单药治疗[0.65(0.49-0.86)],但不优于ACA[0.71(0.49-1.02)]。在上述任何比较中,OS没有显著差异。
    所有新疗法都比化学免疫疗法和免疫疗法具有更好的疗效。在新特工中,VEN+RTX的相对疗效与所有BTKi相似,ZAN优于IBR,与ACA相当。
    PROSPEROCRD42022304330。
    UNASSIGNED: The recent development of new antileukemic therapies (anti-CD20 monoclonal antibodies, Bruton tyrosine kinase inhbitors, phosphoinositide 3-kinase inhibitors, and B-cell lymyphoma-2 antagonists) improved the progression-free survival (PFS) compared with selected standard regimens in clinical trials for patients with relapsed/refractory chronic lymphocytic leukemia (CLL). Unfortunately, the relative efficacy of all possible therapeutic options remains unknown because there is no direct evidence for all possible comparisons.
    UNASSIGNED: We aimed to compare the efficacy and safety of novel agents, chemotherapy, and immunotherapy using a Bayesian network meta-analysis (NMA).
    UNASSIGNED: Systematic literature review with Bayesian NMA.
    UNASSIGNED: An extensive systematic literature review of randomized clinical trials for relapsed/refractory CLL was performed. We searched for articles indexed in medical databases (MEDLINE, Embase, The Cochrane Library) and gray literature that could be further implemented into the Bayesian NMA.
    UNASSIGNED: The systematic search identified 15 randomized trials that formed networks comparing PFS, overall survival (OS), overall response rates, and serious adverse events. Our study showed that all regimens containing novel agents significantly prolonged PFS compared with standard chemoimmunotherapy and immunotherapy. Among targeted drugs, venetoclax (VEN) + rituximab (RTX) had comparable efficacy in terms of PFS to zanubrutinib (ZAN) [hazard ratio (95% credible interval), 1.10 (0.59-2.08)], acalabrutinib (ACA) [0.78 (0.47-1.30)], ibrutinib (IBR) monotherapy [0.72 (0.41-1.27)], and other IBR-based regimens. ZAN was superior to IBR monotherapy [0.65 (0.49-0.86)] but not to ACA [0.71 (0.49-1.02)]. There were no significant differences in OS in any of the above comparisons.
    UNASSIGNED: All novel therapies have better efficacy than chemoimmunotherapy and immunotherapy regimens. Among novel agents, the relative efficacy of VEN + RTX was similar to all BTKi, while ZAN was superior to IBR and comparable to ACA.
    UNASSIGNED: PROSPERO CRD42022304330.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    荟萃分析已经成为行为科学中不可或缺的,合并和总结来自多个研究的数据。虽然它们提供了许多优点(例如,增加功率,更高的普遍性,并解决矛盾的发现),它们目前仅在给定点提供快照。在活跃的研究领域,频繁的元分析更新是必要的,以纳入新的证据。我们提出了现场指导原则,动态荟萃分析,并引入一个使用R环境的可访问工具。我们的APP,由闪亮的包裹提供动力,使元分析师能够以交互方式整合证据,作为现有元分析的更新或从头开始(即,新的荟萃分析)。通过采用动态荟萃分析和利用现代工具,研究人员可以确保在各自领域进行最新的荟萃分析。
    Meta-analyses have become indispensable in the behavioral sciences, combining and summarizing data from multiple studies. While they offer many advantages (e.g., increased power, higher generality, and resolving conflicting findings), they currently only provide a snapshot at a given point. In active research areas, frequent meta-analytic updates are necessary to incorporate new evidence. We propose guidelines for live, dynamic meta-analyses and introduce an accessible tool using the R environment. Our app, powered by the Shiny package, enables the meta-analyst to integrate evidence interactively as an update of an existing meta-analysis or from scratch (i.e., a new meta-analysis). By embracing dynamic meta-analyses and leveraging modern tools, researchers can ensure up-to-date meta-analyses in their respective fields.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    近红外光谱(NIRS)提供了一种高通量的表型鉴定技术,可以帮助育种以改善蚕豆种子的质量。我们结合了蛋白质的化学分析,通过化学计量学与NIRS的油含量(和成分),采用偏最小二乘(PLS),ElasticNet(EN),基于记忆的学习(MBL)和贝叶斯B(BB)作为预测模型。蛋白质是田间试验中最可靠的预测性状(R2=0.96-0.98),其次是油(R2=0.82-0.86)和油酸(R2=0.31-0.68)。使用K均值聚类选择用于训练模型的样本。预测的最佳统计方法是化合物特异性的:蛋白质的PLS(均方根误差-RMSE=0.46),油用BB(RMSE=0.067),和EN表示油酸含量(RMSE=2.83)。减少的训练集模拟显示了对预测精度的不同影响,具体取决于模型和化合物。几个NIR区域被确定为化合物的高度信息,使用EN和BB的收缩和变量选择功能。
    Near-infrared spectroscopy (NIRS) provides a high-throughput phenotyping technique to assist breeding for improved faba bean seed quality. We combined chemical analysis of protein, oil content (and composition) with NIRS through chemometrics, employing Partial Least Squares (PLS), Elastic Net (EN), Memory-based Learning (MBL), and Bayes B (BB) as prediction models. Protein was the most reliably predicted trait (R2 = 0.96-0.98) across field trials, followed by oil (R2 = 0.82-0.86) and oleic acid (R2 = 0.31-0.68). Samples for training the models were selected using K-means clustering. The optimal statistical approach for prediction was compound-specific: PLS for protein (Root Mean Squared Error - RMSE = 0.46), BB for oil (RMSE = 0.067), and EN for oleic acid content (RMSE = 2.83). Reduced training set simulations revealed different effects on prediction accuracy depending on the model and compound. Several NIR regions were pinpointed as highly informative for the compounds, using the shrinkage and variable selection capabilities of EN and BB.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    这项研究探索了数字技术的变革潜力,理论驱动,通过结合数字技术,神经心理学中的贝叶斯范式,致力于评估理论框架,和贝叶斯统计。该研究还研究了大量神经典型个体(N=489)的执行功能和认知灵活性理论。
    我们开发了一个基于互联网的威斯康星卡片分类任务(iWCST),针对坚持错误(PE)的在线评估进行了优化。对PE百分比的预测,PE(%),在非重复和重复的情况下,从建立的监督注意系统(SAS)理论中得出,非重复性PE(%)<重复性PE(%),和新颖的目标导向仪器控制(GIC)理论,非重复性PE(%)>重复性PE(%)。
    贝叶斯t检验揭示了存在稳健的误差抑制效应(ESE),表明PE在重复情况下比在非重复情况下不太可能发生,与SAS理论与后验模型概率p<0.001相矛盾,与后验模型概率p>0.999证实GIC理论。我们得出的结论是,重复的情况通过促进目标导向的检索来支持iWCST中的认知集切换,关联刺激特征的工具记忆,行动,和结果,从而在神经典型个体中产生ESE。我们还报告了探索性数据分析,包括iWCST度量之间关系的贝叶斯网络分析。
    总的来说,这项研究是结合数字技术的范式模型,理论驱动的研究,和神经心理学中的贝叶斯统计。它还提供了对这种综合,创新方法可以促进对执行功能和认知灵活性的理解,并为未来的研究和临床应用提供信息。
    UNASSIGNED: This study explores the transformative potential of digital, theory-driven, and Bayesian paradigms in neuropsychology by combining digital technologies, a commitment to evaluating theoretical frameworks, and Bayesian statistics. The study also examines theories of executive function and cognitive flexibility in a large sample of neurotypical individuals (N = 489).
    UNASSIGNED: We developed an internet-based Wisconsin Card-Sorting Task (iWCST) optimized for online assessment of perseveration errors (PE). Predictions of the percentage of PE, PE (%), in non-repetitive versus repetitive situations were derived from the established supervisory attention system (SAS) theory, non-repetitive PE (%) < repetitive PE (%), and the novel goal-directed instrumental control (GIC) theory, non-repetitive PE (%) > repetitive PE (%).
    UNASSIGNED: Bayesian t-tests revealed the presence of a robust error suppression effect (ESE) indicating that PE are less likely in repetitive situations than in non-repetitive situations, contradicting SAS theory with posterior model probability p < 0.001 and confirming GIC theory with posterior model probability p > 0.999. We conclude that repetitive situations support cognitive set switching in the iWCST by facilitating the retrieval of goal-directed, instrumental memory that associates stimulus features, actions, and outcomes, thereby generating the ESE in neurotypical individuals. We also report exploratory data analyses, including a Bayesian network analysis of relationships between iWCST measures.
    UNASSIGNED: Overall, this study serves as a paradigmatic model for combining digital technologies, theory-driven research, and Bayesian statistics in neuropsychology. It also provides insight into how this integrative, innovative approach can advance the understanding of executive function and cognitive flexibility and inform future research and clinical applications.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    我们开发了一个热力学模型,描述了RNA结合蛋白(RBP)与寡聚物的体外结合。我们应用期望最大化来推断RBP的特异性,表示为特定位置权重矩阵(PWM),通过最大化来自ENCODE项目的RNA绑定\'nSeq数据的可能性。我们证明,该模型可以重现已知的特异性研究良好的蛋白质,在某些情况下,我们预测新的,更长的结合基序。然而,该模型不会恢复原则上已知的所有图案,这表明数据不能被单一的基础生物物理模型很好地解释。我们的代码是公开可用的。
    We develop a thermodynamic model describing the binding of RNA binding proteins (RBP) to oligomers in vitro. We apply expectation-maximization to infer the specificity of RBPs, represented as position-specific weight matrices (PWMs), by maximizing the likelihood of RNA Bind\'n Seq data from the ENCODE project. Analyzing these public data we find sequence motifs that can partly explain the data for more than half of the studied 111 RBPs, and for 48 of the proteins these motifs are consistent with the known specificity. Our code is publicly available, facilitating analysis of RBP binding data.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:根据最新的肺动脉高压(PH)指南,经胸超声心动图(TTE)的主肺动脉(MPA)直径>25mm支持诊断PH。然而,肺动脉(PA)的大小可能会根据身体大小而变化,年龄,和心脏相位。
    目标:1)TTE上PA大小的参考限制是什么,考虑到身体大小的差异,性别,和年龄?2)PA大小对肺动脉高压分类的诊断价值是什么?3)选择不同的参考组(健康志愿者与接受右心导管检查(RHC)的患者)如何影响诊断比值比(DOR)?
    方法:该研究包括248名健康个体作为对照的参考队列,通过RHC证实的693名PH患者,和156例经RHC证实的非PH患者。在PH队列中,300人患有第1组PH,207名患有第2组PH,和186与组-3PH。在胸骨上部短轴和胸骨上切迹视图中测量MPA和右PA(RPA)直径和面积。参考限值(第5-95百分位数)基于绝对值和身高指数测量值。分位数回归分析用于得出PA测量的中值和第95分位数参考方程。然后使用健康对照和非PH队列确定PH的DOR和概率诊断图。
    结果:两种性别的MPA指数直径的第95百分位数在舒张期为15mm/m,收缩期为19mm/m。分位数回归分析显示年龄效应较弱(MPA直径的伪R2为0.08至0.10)。在措施中,舒张期的MPA大小有最高的DOR,156.2(68.3-357.5),用于检测组-1PH。同样,与对照组相比,2组和3组PH的DORs也较高,但与非PH队列相比显著较低.
    结论:该研究提出了基于高度索引和分位数回归的MPA的新参考极限。
    BACKGROUND: According to the most recent pulmonary hypertension (PH) guidelines, a main pulmonary artery (MPA) diameter>25 mm on transthoracic echocardiography (TTE) supports the diagnosis of PH. However, the size of the pulmonary artery(PA) may vary according to body size, age, and cardiac phases.
    OBJECTIVE: 1)What are the reference limits for PA size on TTE, considering differences in body size, sex, and age? 2)What is the diagnostic value of PA size for classifying pulmonary hypertension? 3)How does the selection of different reference groups (healthy volunteers versus patients referred for right heart catheterization (RHC)) influence the diagnostic odds ratio (DOR)?
    METHODS: The study included a reference cohort of 248 healthy individuals as controls, 693 PH patients proven by RHC, and 156 non-PH patients proven by RHC. In the PH cohort, 300 had group-1 PH, 207 had group-2 PH, and 186 with group-3 PH. MPA and right PA(RPA) diameters and areas were measured in the upper sternal short-axis and the suprasternal notch views. Reference limits (5th-95th percentile) were based on absolute values and height-indexed measures. Quantile regression analysis was used to derive median and 95th quantile reference equations for the PA measures. DORs and probability diagnostic plots for PH were then determined using healthy controls and non-PH cohorts.
    RESULTS: The 95th percentile for indexed MPA diameter was 15mm/m in diastole and 19mm/m in systole in both sexes. Quantile regression analysis revealed a weak age effect (pseudo R2 of 0.08 to 0.10 for MPA diameters). Among measures, the MPA size in diastole had the highest DOR, 156.2(68.3-357.5), for detection of group-1 PH. Similarly, the DORs were also high for group-2 and 3 PH when compared to controls but significantly lower compared to non-PH cohort.
    CONCLUSIONS: The study presents novel reference limits for MPA based on height indexing and quantile regression.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号