Developing and Validating a Survival Prediction Model for NSCLC Patients Through Distributed Learning Across 3 Countries.

Purpose: Tools for survival prediction for non-small cell lung cancer (NSCLC) patients treated with chemoradiation or radiation therapy are of limited quality. In this work, we developed a predictive model of survival at 2 years. The model is based on a large volume of historical patient data and se...

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Publicado en:International Journal of Radiation Oncology, Biology, Physics Vol. 99; no. 2; pp. 344 - 353
Autores principales: Jochems, Arthur, Deist, Timo M., El Naqa, Issam, Kessler, Marc, Mayo, Chuck, Reeves, Jackson, Jolly, Shruti, Matuszak, Martha, Ten Haken, Randall, Van Soest, Johan, Oberije, Cary, Faivre-Finn, Corinne, Price, Gareth, De Ruysscher, Dirk, Lambin, Philippe, Dekker, Andre
Formato: research Journal Article
Publicado: Pergamon Press - An Imprint of Elsevier Science Oct2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2017
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      pub: Pergamon Press - An Imprint of Elsevier Science
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        10.1016/j.ijrobp.2017.04.021
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        atl: Developing and Validating a Survival Prediction Model for NSCLC Patients Through Distributed Learning Across 3 Countries.
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        au:
          Jochems, Arthur
          Deist, Timo M.
          El Naqa, Issam
          Kessler, Marc
          Mayo, Chuck
          Reeves, Jackson
          Jolly, Shruti
          Matuszak, Martha
          Ten Haken, Randall
          Van Soest, Johan
          Oberije, Cary
          Faivre-Finn, Corinne
          Price, Gareth
          De Ruysscher, Dirk
          Lambin, Philippe
          Dekker, Andre
        affil: Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
      sug:
        subj:
          Carcinoma, Non-Small-Cell Lung Mortality
          Learning
          Lung Neoplasms Therapy
          Carcinoma, Non-Small-Cell Lung Therapy
          Lung Neoplasms Mortality
          Prospective Studies
          Models, Statistical
          Pharmacokinetics
          Aged
          Female
          Kaplan-Meier Estimator
          Severity of Illness Indices
          Resource Databases
          Neoplasm Staging Standards
          Lymph Nodes Pathology
          Radiotherapy, Conformal Mortality
          Antineoplastic Agents, Combined Therapeutic Use
          Time Factors
          Human
          Male
          Forecasting
          Probability
          Age Factors
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Funding Source
          Aged: 65+ years
          Female
          Male
      ab: Purpose: Tools for survival prediction for non-small cell lung cancer (NSCLC) patients treated with chemoradiation or radiation therapy are of limited quality. In this work, we developed a predictive model of survival at 2 years. The model is based on a large volume of historical patient data and serves as a proof of concept to demonstrate the distributed learning approach.Methods and Materials: Clinical data from 698 lung cancer patients, treated with curative intent with chemoradiation or radiation therapy alone, were collected and stored at 2 different cancer institutes (559 patients at Maastro clinic (Netherlands) and 139 at Michigan university [United States]). The model was further validated on 196 patients originating from The Christie (United Kingdon). A Bayesian network model was adapted for distributed learning (the animation can be viewed at https://www.youtube.com/watch?v=ZDJFOxpwqEA). Two-year posttreatment survival was chosen as the endpoint. The Maastro clinic cohort data are publicly available at https://www.cancerdata.org/publication/developing-and-validating-survival-prediction-model-nsclc-patients-through-distributed, and the developed models can be found at www.predictcancer.org.Results: Variables included in the final model were T and N category, age, performance status, and total tumor dose. The model has an area under the curve (AUC) of 0.66 on the external validation set and an AUC of 0.62 on a 5-fold cross validation. A model based on the T and N category performed with an AUC of 0.47 on the validation set, significantly worse than our model (P<.001). Learning the model in a centralized or distributed fashion yields a minor difference on the probabilities of the conditional probability tables (0.6%); the discriminative performance of the models on the validation set is similar (P=.26).Conclusions: Distributed learning from federated databases allows learning of predictive models on data originating from multiple institutions while avoiding many of the data-sharing barriers. We believe that distributed learning is the future of sharing data in health care.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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