Using elastic nets to estimate frailty burden from routinely collected national aged care data

Abstract Objectives To (1) use an elastic net (EN) algorithm to derive a frailty measure from a national aged care eligibility assessment program; (2) compare the ability of EN-based and a traditional cumulative deficit (CD) based frailty measures to predict mortality and entry into permanent residential care; (3) assess if the predictive ability can be improved by using weighted frailty measures. Materials and Methods A Cox proportional hazard model based EN algorithm was applied to the 2003–2013 cohort of 903 996 participants for selecting items to enter an EN based frailty measure. The out-of-sample predictive accuracy was measured by the area under the curve (AUC) from Cox models fitted to 80% training and validated on 20% testing samples. Results The EN approach resulted in a 178-item frailty measure including items excluded from the 44-item CD-based measure. The EN based measure was not statistically significantly different from the CD-based approach in terms of predicting mortality (AUC 0.641, 95% CI: 0.637–0.644 vs AUC 0.637, 95% CI: 0.634–0.641) and permanent care entry (AUC 0.626, 95% CI: 0.624–0.629 vs AUC 0.627, 95% CI: 0.625–0.63). However, the weighted EN based measure statistically outperforms the weighted CD measure for predicting mortality (AUC 0.774, 95% CI: 0.771–0.777 vs AUC 0.757, 95% CI: 0.754–0.760) and permanent care entry (AUC 0.676, 95% CI: 0.673–0.678 vs AUC 0.671, 95% CI: 0.668–0.674). Conclusions The weighted EN and CD-based measures demonstrated similar prediction performance. The CD-based measure items are relevant to frailty measurement and easier to interpret. We recommend using the weighted and unweighted CD-based frailty measures.

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PREDICTIVE ABILITY OF SEVEN DOMAINS OF THE KIHON CHECKLIST FOR INCIDENT DEPENDENCY AND MORTALITY

Journal of Frailty & Aging ◽

10.14283/jfa.2019.3 ◽

2019 ◽

pp. 1-3

Author(s):

S. Satake ◽

H. Shimokata ◽

K. Senda ◽

I. Kondo6 ◽

H. Arai ◽

...

Keyword(s):

Activities Of Daily Living ◽

Daily Living ◽

Predictive Ability ◽

Cox Proportional Hazard Model ◽

Proportional Hazard ◽

Proportional Hazard Model ◽

Cox Proportional Hazard ◽

Risk Of Mortality ◽

All Cause Mortality ◽

Structured Questionnaire

The Kihon Checklist (KCL) is a structured questionnaire consisting of 7 domains to assess seniors’ function in daily living. The aim of this study was to examine which domains of the KCL can predict incident dependency and mortality. The municipality sent a KCL questionnaire to independent seniors in Higashi-ura Town and collected the answers of the 5542 seniors who provided complete answers. Their incident dependency and mortality were followed-up for 2.5 years. A Cox proportional hazard model indicated that meeting any of the criteria in instrumental activities of daily living, physical, nutrition, and mood domains significantly predicted the risk of dependency, whereas meeting any of the criteria in physical, nutrition and socialization domains significantly predicted the risk of mortality. Category assessment by the KCL could be useful to predict incident dependency and all-cause mortality.

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Validation of a Simplified International Prognostic Score (IPS-3) in Patients with Advanced Stage Hodgkin Lymphoma

Blood ◽

10.1182/blood-2018-99-111047 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 2916-2916

Author(s):

Anna R Hayden ◽

Derrick G Lee ◽

Diego Villa ◽

Alina S. Gerrie ◽

David W. Scott ◽

...

Keyword(s):

Hodgkin Lymphoma ◽

Research Funding ◽

Predictive Accuracy ◽

Prognostic Score ◽

Risk Groups ◽

Advanced Stage ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

International Prognostic Score ◽

Modern Era

Abstract Purpose Since its publication in 1998, the International Prognostic Score (IPS-7) has been widely adopted as a risk stratification tool in patients with advanced stage classical Hodgkin lymphoma (cHL).1 In this study, the 5-y freedom-from-progression (FFP) ranged from 42 to 84% and 5-y overall survival (OS) from 56 to 89%. This index has demonstrated utility in the modern era, but with a significantly narrowed prognostic range.2 Further, missing factors can be problematic, limiting utility in clinical practice. A novel prognostic score (IPS-3), comprised of three of the seven IPS-7 indicators (age ≥ 45, stage IV, hemoglobin < 105), was proposed with data derived from advanced stage cHL patients enrolled on the E2496 clinical trial comparing ABVD to Stanford V.3 This model was reported to outperform the IPS-7 in predicting 5-y FFP and OS. We aimed to validate the IPS-3 model in advanced stage cHL treated with ABVD or ABVD equivalent chemotherapy in British Columbia. Patients and Methods The BC Cancer Lymphoid Cancer database was used to identify all advanced stage cHL patients (stage 1/2 bulky, stage 2B, stage 3/4), age ≥ 16 years, diagnosed between January 1, 1980 and June 6, 2018, treated with curative intent ABVD or an ABVD-equivalent regimen with available information for all seven IPS variables. Kaplan-Meier method and Cox proportional hazard models were used to estimate survival rates, hazard ratios (HRs), and 95% CIs. FFP was defined as time from date of diagnosis to disease progression or relapse. Log-rank testing was used to compare the survival curves between groups. As previously described3, prognostic performance and predictive accuracy of IPS-7 and IPS-3 were evaluated using concordance probability estimates (CPEs) with a Cox proportional hazard model based on risk groups. Results 1191 patients were identified. Median age was 33 years (range 16 to 85), 30% were ≥45 years of age and 9% were >65 years of age, 55% were male and 22% had a high risk IPS-7 (≥4). Patient characteristics were similar to the E2946 cohort used to create the IPS-3 (Table 1). Furthermore, estimates of 5-y FFP and 5-y OS in the risk groups were very similar to those in the original report3 (Table 2). In the BC IPS-7 patients, 5-y FFP ranged from 65% to 91% (p<.001) and 5-y OS ranged from 68 to 99% (p<.001) and the IPS-3 model predicted a 5-y FFP of 84% ±2 for a score of 0, 76% ±2 for a score of 1 (HR 1.5, 95% CI 1.2 to 2.1), 72% ±4 for a score of 2 (HR 1.9, 95% CI 1.4 to 2.7) and 68% ±7 for a score of 3 (HR 2.4, 95% CI 1.4 to 4.2) and corresponding values for 5-y OS were 95% ±1, 87% ±2 (HR 3.5, 95% CI 2.4 to 5.1), 80% ±3 (HR 5.1 95% CI 3.4 to 7.7) and 61% ±8 (HR 9.0 95% CI 5.2 to 15.8). Restricting the analysis to patients 65 years of age and younger in our cohort (N = 1080), values for 5-y FFP were similar to the full cohort, ranging from 67 to 84% for IPS-3 and 69 to 91% for IPS-7. Values were slightly improved for OS, ranging from 70 to 95% for IPS-3 and 76 to 99% for IPS-7. Both the IPS-7 and the IPS-3 scores were not effective for predicting 5-y FFP or OS when applied to patients older than 65 years of age (all P≥0.54, N=111). Predictive accuracy and discriminatory performance were evaluated by CPE with higher scores associated with greater accuracy. CPEs for OS were 0.63 (SE 0.014) and 0.66 (SE 0.014) for IPS-7 and IPS-3, respectively. This result may suggest a better concordance between the observed data and IPS-3; however, there was a reversal in performance when analyzing FFP, as the CPEs for FFP were 0.59 (SE 0.014) and 0.57 (SE 0.015) for IPS-7 and IPS-3 respectively. Conclusion This population-based study confirms that both IPS-3 and IPS-7 are prognostic in advanced stage cHL patients treated with ABVD. Unlike the original study evaluating the IPS-3, we did not find overwhelming evidence to suggest that the IPS-3 was more accurate for predicting prognosis than the IPS-7; however, given its simplicity and comparable performance to the IPS-7, IPS-3 may be more appealing for application in the clinical setting. References:Hasenclever D, et al: A prognostic score for advanced Hodgkin's disease. International Prognostic Factors Project on Advanced Hodgkin's Disease. N Engl J Med, 1998Moccia AA et al: International Prognostic Score in advanced-stage Hodgkin's lymphoma: altered utility in the modern era. J Clin Oncol, 2012Diefenbach CS et al: Evaluation of the International Prognostic Score (IPS-7) and a Simpler Prognostic Score (IPS-3) for advanced Hodgkin lymphoma in the modern era. Br J Haematol, 2015 Disclosures Scott: Roche: Research Funding; Janssen: Research Funding; Celgene: Consultancy, Honoraria; NanoString: Patents & Royalties: Named Inventor on a patent licensed to NanoString Technologies, Research Funding. Sehn:TG Therapeutics: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Celgene: Consultancy, Honoraria; Amgen: Consultancy, Honoraria; Karyopharm: Consultancy, Honoraria; Morphosys: Consultancy, Honoraria; Lundbeck: Consultancy, Honoraria; Abbvie: Consultancy, Honoraria; Seattle Genetics: Consultancy, Honoraria; Merck: Consultancy, Honoraria; Roche/Genentech: Consultancy, Honoraria. Connors:NanoString Technologies: Patents & Royalties: Named Inventor on a patent licensed to NanoString Technologies, Research Funding; Cephalon: Research Funding; Merck: Research Funding; Genentech: Research Funding; Takeda: Research Funding; Lilly: Research Funding; Roche Canada: Research Funding; Seattle Genetics: Honoraria, Research Funding; Bristol Myers-Squibb: Research Funding; Janssen: Research Funding; Amgen: Research Funding; Bayer Healthcare: Research Funding; F Hoffmann-La Roche: Research Funding.

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Fusion of KATZ measure and space projection to fast probe potential lncRNA-disease associations in bipartite graphs

PLoS ONE ◽

10.1371/journal.pone.0260329 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0260329

Author(s):

Yi Zhang ◽

Min Chen ◽

Li Huang ◽

Xiaolan Xie ◽

Xin Li ◽

...

Keyword(s):

Computational Methods ◽

Predictive Accuracy ◽

Attenuation Factor ◽

Area Under The Curve ◽

Predictive Ability ◽

Bipartite Graphs ◽

Computational Method ◽

Disease Associations ◽

Space Projection ◽

Leave One Out

It is well known that numerous long noncoding RNAs (lncRNAs) closely relate to the physiological and pathological processes of human diseases and can serves as potential biomarkers. Therefore, lncRNA-disease associations that are identified by computational methods as the targeted candidates reduce the cost of biological experiments focusing on deep study furtherly. However, inaccurate construction of similarity networks and inadequate numbers of observed known lncRNA–disease associations, such inherent problems make many mature computational methods that have been developed for many years still exit some limitations. It motivates us to explore a new computational method that was fused with KATZ measure and space projection to fast probing potential lncRNA-disease associations (namely KATZSP). KATZSP is comprised of following key steps: combining all the global information with which to change Boolean network of known lncRNA–disease associations into the weighted networks; changing the similarities calculation into counting the number of walks that connect lncRNA nodes and disease nodes in bipartite graphs; obtaining the space projection scores to refine the primary prediction scores. The process to fuse KATZ measure and space projection was simplified and uncomplicated with needing only one attenuation factor. The leave-one-out cross validation (LOOCV) experimental results showed that, compared with other state-of-the-art methods (NCPLDA, LDAI-ISPS and IIRWR), KATZSP had a higher predictive accuracy shown with area-under-the-curve (AUC) value on the three datasets built, while KATZSP well worked on inferring potential associations related to new lncRNAs (or isolated diseases). The results from real cases study (such as pancreas cancer, lung cancer and colorectal cancer) further confirmed that KATZSP is capable of superior predictive ability to be applied as a guide for traditional biological experiments.

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D-dimers at hospital admission for COVID-19 are associated with in hospital mortality independently of venous thromboembolism: Insight from a French multicenter cohort study

10.21203/rs.3.rs-62363/v1 ◽

2020 ◽

Author(s):

Richard Chocron ◽

Baptiste Duceau ◽

Nicolas Gendron ◽

Nacim Ezzouhairi ◽

Lina Khider ◽

...

Keyword(s):

Venous Thromboembolism ◽

Hospital Mortality ◽

Area Under The Curve ◽

Proportional Hazard ◽

Roc Curve Analysis ◽

Multicenter Cohort Study ◽

Logistic Regression Models ◽

Cox Proportional Hazard ◽

Medical Wards ◽

D Dimer

Abstract Background: Coronavirus disease 2019 (COVID-19) has been associated with coagulation disorders, in particular high levels of D-dimers, and increased frequency of venous thromboembolism (VTE). We explore the association between D-dimers at admission and in-hospital mortality in hospitalized COVID-19 patients with or without symptomatic VTE.Methods: From February 26 to April 20, 2020, D-dimer level at admission and outcomes of patients hospitalized for COVID-19 in medical wards (in-hospital mortality or VTE) were retrospectively analyzed in a multicenter study in 24 French hospitals.Results: Among 2878 patients enrolled in the study, 1154 (40.9%) patients had D-dimer measurement at admission. A receiver operating characteristic (ROC) curve analysis identified D-dimer level above 1128 ng/mL as the optimum cutoff value to predict in-hospital mortality (Area Under the Curve of 64.9% (95% CI 0.60–0.69) with a sensitivity of 71.1% (95% CI 0.62–0.78) and a specificity of 55.6% (95% CI 0.52–0.58) that not differ in the subgroup of patients with VTE during hospitalization. Among 609 (52.8%) patients with D-dimers level < 1128 ng/mL at admission, only 35 (5.7%) deaths occurred during hospitalization. After adjustment, in a cox proportional hazard and logistic regression models, D-dimers above 1128 ng/mL at admission were also associated to a worth prognosis with a OR of 3.07 (95% CI 2.05–4.69, p < 0.001) and an unadjusted hazard ratio of 2.11 (95%CI 1.31–3.4, p < 0.01).Conclusions: D-dimer level over 1128 ng/mL is a relevant predictive factor for in-hospital mortality in COVID-19 hospitalized patients in medical ward, regardless the occurrence of VTE during hospitalization.

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A Study of Factors Affecting the Length of Hospital Stay of COVID-19 Patients by Cox-Proportional Hazard Model in a South Indian Tertiary Care Hospital

Journal of Primary Care & Community Health ◽

10.1177/21501327211000231 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110002

Author(s):

Gayathri Thiruvengadam ◽

Marappa Lakshmi ◽

Ravanan Ramanujam

Keyword(s):

Hospital Stay ◽

Tertiary Care ◽

Length Of Hospital Stay ◽

Hazard Model ◽

Cox Proportional Hazard Model ◽

Care Hospital ◽

Proportional Hazard ◽

Proportional Hazard Model ◽

Cox Proportional Hazard ◽

South Indian

Background: The objective of the study was to identify the factors that alter the length of hospital stay of COVID-19 patients so we have an estimate of the duration of hospitalization of patients. To achieve this, we used a time to event analysis to arrive at factors that could alter the length of hospital stay, aiding in planning additional beds for any future rise in cases. Methods: Information about COVID-19 patients was collected between June and August 2020. The response variable was the time from admission to discharge of patients. Cox proportional hazard model was used to identify the factors that were associated with the length of hospital stay. Results: A total of 730 COVID-19 patients were included, of which 675 (92.5%) recovered and 55 (7.5%) were considered to be right-censored, that is, the patient died or was discharged against medical advice. The median length of hospital stay of COVID-19 patients who were hospitalized was found to be 7 days by the Kaplan Meier curve. The covariates that prolonged the length of hospital stay were found to be abnormalities in oxygen saturation (HR = 0.446, P < .001), neutrophil-lymphocyte ratio (HR = 0.742, P = .003), levels of D-dimer (HR = 0.60, P = .002), lactate dehydrogenase (HR = 0.717, P = .002), and ferritin (HR = 0.763, P = .037). Also, patients who had more than 2 chronic diseases had a significantly longer length of stay (HR = 0.586, P = .008) compared to those with no comorbidities. Conclusion: Factors that are associated with prolonged length of hospital stay of patients need to be considered in planning bed strength on a contingency basis.

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Low serum parathyroid hormone is a risk factor for peritonitis episodes in incident peritoneal dialysis patients: a retrospective study

BMC Nephrology ◽

10.1186/s12882-021-02241-0 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Yuqi Yang ◽

Jingjing Da ◽

Yi Jiang ◽

Jing Yuan ◽

Yan Zha

Keyword(s):

Risk Factor ◽

Peritoneal Dialysis ◽

Parathyroid Hormone ◽

Proportional Hazard ◽

Serum Parathyroid Hormone ◽

Cox Proportional Hazard ◽

Cox Proportional Hazard Regression ◽

Gram Negative Organisms ◽

Serum Pth

Abstract Background Serum parathyroid hormone (PTH) levels have been reported to be associated with infectious mortality in peritoneal dialysis (PD) patients. Peritonitis is the most common and fatal infectious complication, resulting in technique failure, hospital admission and mortality. Whether PTH is associated with peritonitis episodes remains unclear. Methods We examined the association of PTH levels and peritonitis incidence in a 7-year cohort of 270 incident PD patients who were maintained on dialysis between January 2012 and December 2018 using Cox proportional hazard regression analyses. Patients were categorized into three groups by serum PTH levels as follows: low-PTH group, PTH < 150 pg/mL; middle-PTH group, PTH 150-300 pg/mL; high-PTH group, PTH > 300 pg/mL. Results During a median follow-up of 29.5 (interquartile range 16–49) months, the incidence rate of peritonitis was 0.10 episodes per patient-year. Gram-positive organisms were the most common causative microorganisms (36.2%), and higher percentage of Gram-negative organisms was noted in patients with low PTH levels. Low PTH levels were associated with older age, higher eGFR, higher hemoglobin, calcium levels and lower phosphate, alkaline phosphatase levels. After multivariate adjustment, lower PTH levels were identified as an independent risk factor for peritonitis episodes [hazard ratio 1.643, 95% confidence interval 1.014–2.663, P = 0.044]. Conclusions Low PTH levels are independently associated with peritonitis in incident PD patients.

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POS1329 A COHORT STUDY ON THE RISK OF DEVELOPING OBSTRUCTIVE SLEEP APNEA, TEMPOROMANDIBULAR JOINT DISORDERS AND CRANIOFACIAL DEFORMITIES IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3961 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 947.1-947

Author(s):

K. S. K. MA ◽

L. T. Wang

Keyword(s):

Obstructive Sleep Apnea ◽

Cohort Study ◽

Juvenile Idiopathic Arthritis ◽

Cox Proportional Hazard Model ◽

Proportional Hazard ◽

Proportional Hazard Model ◽

Cox Proportional Hazard ◽

Obstructive Sleep ◽

Subgroup Analyses ◽

Underlying Mechanisms

Background:Juvenile Idiopathic Arthritis (JIA), an autoimmune disease, has been proposed to be comorbid with obstructive sleep apnea (OSA).Objectives:We aimed at identifying the relationship between JIA and OSA.Methods:We performed a cohort study including JIA and OSA patients from 1999 to 2013. A total of 2791 patients diagnosed with OSA after JIA onset were recruited, which 11,164 eligible individuals without JIA history were selected as matched-controls. A Cox proportional hazard model was developed to estimate the risk of OSA in JIA patients. A cumulative probability model was adopted to assess the time-dependent effect of JIA on OSA development, implying the casual link of the association. To identify whether JIA patients have higher risks for developing temporomandibular joint (TMJ) disorders, craniofacial anomalies and deformities than non-JIA individuals, subgroup analyses was conducted. Finally, Ingenuity Systems Pathway Analysis (IPA) was conducted to identify underlying mechanisms of the above disease correlation among peripheral blood mononuclear cells (PBMCs) from rheumatic factor (RF)-positive and RF-negative JIA patients, and subcutaneous fat tissues from OSA patients, using p-value visualization for RNA-seq analyses.Results:The Cox proportional hazard model showed that JIA patients were more likely to have OSA than non-JIA individuals (adjusted hazard ratio =1.949, 95% CI =1.264–3.005). The incidence of developing OSA was particularly high among patients who developed JIA aged 18-30 years old (aHR= 2.034, 95% CI=1.305-3.169) and males (aHR=1.82, 95% CI=1.121-2.954). The risk of developing OSA increased within 0-36 months (aHR = 2.216, 95% CI = 1.001 – 4.907) and over 60 months (aHR = 2.558, 95% CI = 1.346 – 4.860) of follow-up duration after JIA onset. Subgroup analyses showed that JIA patients were more likely to have TMJ disorders (relative risk = 2.047, 95% CI = 1.446-2.898) and to receive treatment for craniofacial deformities (RR = 1.722, 95% CI = 1.38-2.148) than non-JIA controls. IPA analyses suggested that the underlying mechanisms involved activation of antigen presentation pathway followed by antigen presentation to CD4+ and CD8+ T lymphocytes, as well as B cell development.Conclusion:Our findings identified high risks of developing OSA, TMJ disorders, and craniofacial deformities following JIA onset, which the underlying mechanisms may involve both cellular and humoral immunity.Disclosure of Interests:None declared

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LAMB1 Is Related to the T Stage and Indicates Poor Prognosis in Gastric Cancer

Technology in Cancer Research & Treatment ◽

10.1177/15330338211004944 ◽

2021 ◽

Vol 20 ◽

pp. 153303382110049

Author(s):

Tao Ran ◽

ZhiJi Chen ◽

LiWen Zhao ◽

Wei Ran ◽

JinYu Fan ◽

...

Keyword(s):

Gastric Cancer ◽

Poor Prognosis ◽

Hazard Models ◽

Proportional Hazard ◽

Kegg Analysis ◽

Proportional Hazard Models ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Cox Proportional Hazard Models ◽

Gastric Cancer Patients

Background and Objective: Gastric cancer (GC) is a common tumor malignancy with high incidence and poor prognosis. Laminin is an indispensable component of basement membrane and extracellular matrix, which is responsible for bridging the internal and external environment of cells and transmitting signals. This study mainly explored the association of the LAMB1 expression with clinicopathological characteristics and prognosis in gastric cancer. Methods: The expression data and clinical information of gastric cancer patients were downloaded from The Cancer Genome Atlas (TCGA) and Asian Cancer Research Group (ACRG). And we analyzed the relationship between LAMB1 expression and clinical characteristics through R. CIBERSORTx was used to calculate the absolute score of immune cells in gastric tumor tissues. Then COX proportional hazard models and Kaplan-Meier curves were performed to evaluate the role of LAMB1 and its influence on prognosis in gastric cancer patients. Finally, GO and KEGG analysis were applied for LAMB1-related genes in gastric cancer, and PPI network was constructed in Cytoscape software. Results: In the TCGA cohort, patients with gastric cancer frequently generated LAMB1 gene copy number variation, but had little effect on mRNA expression. Both in the TCGA and ACRG cohorts, the mRNA expression of LAMB1 in gastric cancer tissues was higher than it in normal tissues. All patients were divided into high expression group and low expression group according to the median expression level of LAMB1. The elevated expression group obviously had more advanced cases and higher infiltration levels of M2 macrophages. COX proportional hazard models and Kaplan-Meier curves revealed that patients with enhanced expression of LAMB1 have a worse prognosis. GO/KEGG analysis showed that LAMB1-related genes were enriched in PI3K-Akt signaling pathway, focal adhesion, ECM-receptor interaction, etc. Conclusions: The high expression of LAMB1 in gastric cancer is related to the poor prognosis of patients, and it may be related to microenvironmental changes in tumors.

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Comparing the characteristics and predicting the survival of patients with head and neck melanoma versus body melanoma: a population-based study

BMC Cancer ◽

10.1186/s12885-021-08105-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yuxin Ding ◽

Runyi Jiang ◽

Yuhong Chen ◽

Jing Jing ◽

Xiaoshuang Yang ◽

...

Keyword(s):

Head And Neck ◽

Health Management ◽

External Validation ◽

Area Under The Curve ◽

Population Based ◽

Survival Prediction ◽

Cancer Specific Survival ◽

Cox Models ◽

Lentigo Maligna Melanoma ◽

Clinical Tools

Abstract Background Previous studies reported cutaneous melanoma in head and neck (HNM) differed from those in other regions (body melanoma, BM). Individualized tools to predict the survival of patients with HNM or BM remain insufficient. We aimed at comparing the characteristics of HNM and BM, developing and validating nomograms for predicting the survival of patients with HNM or BM. Methods The information of patients with HNM or BM from 2004 to 2015 was obtained from the Surveillance, Epidemiology, and End Results (SEER) database. The HNM group and BM group were randomly divided into training and validation cohorts. We used the Kaplan-Meier method and multivariate Cox models to identify independent prognostic factors. Nomograms were developed via the rms and dynnom packages, and were measured by the concordance index (C-index), the area under the curve (AUC) of the receiver operating characteristic (ROC) curve and calibration plots. Results Of 70,605 patients acquired, 21% had HNM and 79% had BM. The HNM group contained more older patients, male sex and lentigo maligna melanoma, and more frequently had thicker tumors and metastases than the BM group. The 5-year cancer-specific survival (CSS) and overall survival (OS) rates were 88.1 ± 0.3% and 74.4 ± 0.4% in the HNM group and 92.5 ± 0.1% and 85.8 ± 0.2% in the BM group, respectively. Eight variables (age, sex, histology, thickness, ulceration, stage, metastases, and surgery) were identified to construct nomograms of CSS and OS for patients with HNM or BM. Additionally, four dynamic nomograms were available on web. The internal and external validation of each nomogram showed high C-index values (0.785–0.896) and AUC values (0.81–0.925), and the calibration plots showed great consistency. Conclusions The characteristics of HNM and BM are heterogeneous. We constructed and validated four nomograms for predicting the 3-, 5- and 10-year CSS and OS probabilities of patients with HNM or BM. These nomograms can serve as practical clinical tools for survival prediction and individual health management.

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Validation and verification of predictive salivary biomarkers for oral health

Scientific Reports ◽

10.1038/s41598-021-85120-w ◽

2021 ◽

Vol 11 (1) ◽

Cited By ~ 1

Author(s):

Nagihan Bostanci ◽

Konstantinos Mitsakakis ◽

Beral Afacan ◽

Kai Bao ◽

Benita Johannsen ◽

...

Keyword(s):

Oral Health ◽

Predictive Accuracy ◽

Statistical Tests ◽

Area Under The Curve ◽

Regression Tree ◽

High Sensitivity ◽

Oral Health Status ◽

Classification And Regression Tree ◽

Cart Analysis ◽

Salivary Biomarkers

AbstractOral health is important not only due to the diseases emerging in the oral cavity but also due to the direct relation to systemic health. Thus, early and accurate characterization of the oral health status is of utmost importance. There are several salivary biomarkers as candidates for gingivitis and periodontitis, which are major oral health threats, affecting the gums. These need to be verified and validated for their potential use as differentiators of health, gingivitis and periodontitis status, before they are translated to chair-side for diagnostics and personalized monitoring. We aimed to measure 10 candidates using high sensitivity ELISAs in a well-controlled cohort of 127 individuals from three groups: periodontitis (60), gingivitis (31) and healthy (36). The statistical approaches included univariate statistical tests, receiver operating characteristic curves (ROC) with the corresponding Area Under the Curve (AUC) and Classification and Regression Tree (CART) analysis. The main outcomes were that the combination of multiple biomarker assays, rather than the use of single ones, can offer a predictive accuracy of > 90% for gingivitis versus health groups; and 100% for periodontitis versus health and periodontitis versus gingivitis groups. Furthermore, ratios of biomarkers MMP-8, MMP-9 and TIMP-1 were also proven to be powerful differentiating values compared to the single biomarkers.

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