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2016 ; 25
(6
): 2972-2991
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Individualized dynamic prediction of prostate cancer recurrence with and without
the initiation of a second treatment: Development and validation
#MMPMID24847900
Sène M
; Taylor JM
; Dignam JJ
; Jacqmin-Gadda H
; Proust-Lima C
Stat Methods Med Res
2016[Dec]; 25
(6
): 2972-2991
PMID24847900
show ga
With the emergence of rich information on biomarkers after treatments, new types
of prognostic tools are being developed: dynamic prognostic tools that can be
updated at each new biomarker measurement. Such predictions are of interest in
oncology where after an initial treatment, patients are monitored with repeated
biomarker data. However, in such setting, patients may receive second treatments
to slow down the progression of the disease. This paper aims to develop and
validate dynamic individual predictions that allow the possibility of a new
treatment in order to help understand the benefit of initiating new treatments
during the monitoring period. The prediction of the event in the next x years is
done under two scenarios: (1) the patient initiates immediately a second
treatment, (2) the patient does not initiate any treatment in the next x years.
Predictions are derived from shared random-effect models. Applied to prostate
cancer data, different specifications for the dependence between the
prostate-specific antigen repeated measures, the initiation of a second treatment
(hormonal therapy), and the risk of clinical recurrence are investigated and
compared. The predictive accuracy of the dynamic predictions is evaluated with
two measures (Brier score and prognostic cross-entropy) for which approximated
cross-validated estimators are proposed.