用集成学习融合多种模型,提升肝病患者生存风险预测精度。
Ensemble Machine Learning and Statistical Procedures for Dynamic Predictions of Time-to-Event Outcomes
- 构建可灵活组合不同模型的集成预测框架。
- 在原发性胆汁性肝硬化数据上表现优于单一模型。
- 适合需要高精度动态预测的医学决策场景。
纵向和时间事件结果的动态预测已成为精准医疗中的重要工具。本研究以原发性胆汁性肝硬化患者为背景,其定期检测的生物标志物(如胆红素、碱性磷酸酶水平)用于评估肝衰竭风险并指导临床决策。现有主流方法包括联合建模与地标法,近年也引入了机器学习技术。但各方法各有优劣,尚无一种方法能全面胜出。为此,我们扩展了Super Learner集成学习框架,整合来自不同模型和方法的动态预测结果。Super Learner通过交叉验证和适配特定应用的目标函数(如平方损失),自动学习最优加权组合。在原发性胆汁性肝硬化案例中,该方法因能灵活融合多种假设不同的模型,在预测性能上达到或超越单独使用任一模型的效果。
原文摘要 · Abstract (English)
Dynamic predictions for longitudinal and time-to-event outcomes have become a versatile tool in precision medicine. Our work is motivated by the application of dynamic predictions in the decision-making process for primary biliary cholangitis patients. For these patients, serial biomarker measurements (e.g., bilirubin and alkaline phosphatase levels) are routinely collected to inform treating physicians of the risk of liver failure and guide clinical decision-making. Two popular statistical approaches to derive dynamic predictions are joint modelling and landmarking. However, recently, machine learning techniques have also been proposed. Each approach has its merits, and no single method exists to outperform all others. Consequently, obtaining the best possible survival estimates is challenging. Therefore, we extend the Super Learner framework to combine dynamic predictions from different models and procedures. Super Learner is an ensemble learning technique that allows users to combine different prediction algorithms to improve predictive accuracy and flexibility. It uses cross-validation and different objective functions of performance (e.g., squared loss) that suit specific applications to build the optimally weighted combination of predictions from a library of candidate algorithms. In our work, we pay special attention to appropriate objective functions for Super Learner to obtain the most optimal weighted combination of dynamic predictions. In our primary biliary cholangitis application, Super Learner presented unique benefits due to its ability to flexibly combine outputs from a diverse set of models with varying assumptions for equal or better predictive performance than any model fit separately.
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