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Bayesian analysis of mutational spectra.

Studies that examine both the frequency of gene mutation and the pattern or spectrum of mutational changes can be used to identify chemical mutagens and to explore the molecular mechanisms of mutagenesis. In this article, we propose a Bayesian hierarchical modeling approach for the analysis of mutational spectra. We assume that the total number of independent mutations and the numbers of mutations falling into different response categories, defined by location within a gene and/or type of alteration, follow binomial and multinomial sampling distributions, respectively. We use prior distributions to summarize past information about the overall mutation frequency and the probabilities corresponding to the different mutational categories. These priors can be chosen on the basis of data from previous studies using an approach that accounts for heterogeneity among studies. Inferences about the overall mutation frequency, the proportions of mutations in each response category, and the category-specific mutation frequencies can be based on posterior distributions, which incorporate past and current data on the mutant frequency and on DNA sequence alterations. Methods are described for comparing groups and for assessing dose-related trends. We illustrate our approach using data from the literature.

Animals↗

Estimating defibrillation efficacy using combined upper limit of vulnerability and defibrillation testing.

It is frequently necessary, both clinically and in the laboratory, to estimate how strong a stimulus is required to defibrillate. Current techniques for forming such estimates require the repeated induction of ventricular fibrillation (VF) and subsequent attempts at defibrillation (DF testing). DF testing can be time consuming and in the operating room may increase the patient risks. A novel scheme is presented which combines DF testing with upper limit of vulnerability (ULV) testing. ULV testing is a relatively safe procedure which yields data well correlated with defibrillation efficacy. A Bayesian statistical model of combined ULV/DF testing is presented which is both powerful and concise. The model is used in two examples to design minimum rms error protocols and estimators for the DF95 (the stimulus strength which defibrillates 95% of the time). A simulation for humans of one example solution shows that a single VF episode of combined ULV/DF testing (rms error = 23% of the mean DF95) is better than two VF episodes with DF testing alone (25%). The simulation results for a second example are directly compared with laboratory results from six pigs, showing a less than 1.0% average difference between the simulated and measured rms errors.

Algorithms↗

Computer-assisted identification of anaerobic bacteria.

A computer program was developed to identify anaerobic bacteria by using simultaneous pattern recognition via a Bayesian probabilistic model. The system is intended for use as a rapid, precise, and reproducible aid in the identification of unknown isolates. The program operates on a data base of 28 genera comprising 238 species of anaerobic bacteria that can be separated by the program. Input to the program consists of biochemical and gas chromatographic test results in binary format. The system is flexible and yields outputs of: (i) most probable species, (ii) significant test results conflicting with established data, and (iii) differential tests of significance for missing test results.

Anaerobiosis↗

How to construct a subjective index.

We present a method of constructing quantitative indices, which is based on the subjective opinions of a panel of experts, and discuss how a Bayesian probability model and panel opinions can be used together to produce an index. Among the advantages of the method are its face validity and ease of construction. Research shows that when expert opinions are solicited according to certain guidelines, subjective methods may be as accurate as the more objective ones. Guidelines along with a brief report of a recent application are also discussed.

Abstracting and Indexing↗

Medical decision making in the choice of a thrombolytic agent for acute myocardial infarction. Quebec Acute Coronary Care Working Group.

Little is known about how physicians make decisions when the evidence is incomplete or controversial. While thrombolysis improves survival following acute myocardial infarction (AMI), conflicting evidence exists as to any specific agent's superiority, particularly if cost-effectiveness is considered. Using a Bayesian hierarchical model, the authors examined the patient, physician, and hospital characteristics that are related to the decision-making process concerning the choice of thrombolytic agent in a prospective registry of 1,165 AMI patients receiving thrombolysis. Tissue plasminogen activator (t-PA) was administered to 432 patients (31.8%) and streptokinase (SK) to the remainder. The presence of an anterior infarction, a previous myocardial infarction, low blood pressure, a cardiologist decision maker, younger age, and receiving treatment within six hours after the start of symptoms were independent predictors of receiving t-PA. The levels of importance that physicians accorded to these patient characteristics differed according to their practicing institutions. Generally, they followed evidence-based medicine and reasonably targeted high-risk patients to receive the more expensive t-PA. However, they also preferentially treated younger patients, where only a small absolute advantage appears to exist.

Aged↗

Genomic background of gestation length and calving-related traits in Holstein cattle.

The reproductive success of cows directly influences the profitability of dairy farms. Reproductive traits, particularly calving-related traits, generally have low heritability but sufficient additive genetic variance to enable genetic progress through genomic selection. Thus, the primary objectives of this study were to estimate genetic parameters and perform single-step genome-wide association studies (ssGWAS) for calf size, calving ease, gestation length, and stillbirth in Holstein cattle. Variance components were estimated based on animal models and Bayesian inference using a data set containing 226,717 animals with phenotypic records, 15,761 animals genotyped with 45,101 SNP markers, and 461,819 animals in the pedigree. SNP effects were estimated using the single-step GBLUP method. For direct and maternal genetic effects, heritability estimates (posterior standard deviation) ranged from 0.001 (0.002) for gestation length in heifers to 0.16 (0.001) for gestation length in cows. Genetic correlations ranged from -0.57 (0.01) between calving ease and stillbirth in heifers to 0.74 (0.01) between gestation length evaluated in heifers and cows. The ssGWAS results supported a highly polygenic architecture for calving-related traits, with most genomic signals not reaching genome-wide significance. A genome-wide significant association was detected for calving ease in cows on BTA23, highlighting FARS2 as a positional candidate gene. The strongest GWAS signals for each trait harbored additional biologically important candidate genes, including NPPA, NPPB, BCHE, EPHA4, DLD, and GTF2I. Given the generally low heritability estimates and the predominantly polygenic architecture observed for these traits, genomic selection may contribute to the genetic improvement of calving-related traits in Holstein cattle, with potential benefits for cow welfare, calf survival, and overall dairy production efficiency.

dairy cattle↗

Population pharmacokinetics of methotrexate in the guinea pig.

The population pharmacokinetics of an antitumoral and antiinflammatory agent, methotrexate (MTX), a folic acid antagonist, was studied in guinea pigs. Animals received an acute intraperitoneal injection of 0.25, 1 or 5 mg/kg MTX. Blood sampling was carried out for 12 hrs. after MTX administration and plasma drug concentrations were measured by fluorescence polarization immunoassay. The pharmacokinetic (PK) parameters were computed using the bayesian population model. MTX reached the level of detection at 3 hrs. for the animals injected with the lowest dose (0.25 mg/kg), at 3.5 hrs. for those animals which had the intermediate dose (1 mg/kg) and more than 6 hrs. for animals having received the highest dose (5 mg/kg). Each kinetic parameter (half life, total clearance - CLt, volume of distribution at steady state - VDSS, mean residence time - MRT - and area under curve - AUC) didn't show any significant difference between doses. MTX kinetic was linear for the first two doses (0.25 and 1 mg/kg MTX) and non-linear thereafter. MTX presented a one compartment distribution.

Animals↗

A management tool for controlling the rate of non-acceptable inpatient hospital claims.

This paper demonstrates a tool for substantially improved monitoring of the validity of health insurance claims. Using a Bayesian regression model, we predict the probability of a non-acceptable claim (NAC) for each claim record and the expected number of NACs for any set of claims. When applied to a large set of hospital discharge claims, the tool shows a substantial improvement in the ability to estimate the actual number of NACs in the set. The tool permits ongoing monitoring of claims, more precise control, and a substantial reduction in audit cost in claims administration. It is conceptually applicable to other ongoing quality control systems, where inexpensively obtained information can be used to predict events that are costly to measure directly.

Bayes Theorem↗

Transplantation statistics in the UK--an agenda for the next quinquennium.

Our next quinquennial plan for transplantation studies extends MPI to corneal and unrelated marrow transplantation. It applies Bayesian hierarchical modelling to regional variation in donor procurement and continues a program of special studies to augment national databases with respect to kidney, corneal, heart and liver transplantation. It promotes research collaboration among European and other organ exchange organizations as pioneered in the Council of Europe 1986 Study on High Sensitization, which showed the effectiveness of the network of European organ exchange organizations in liaising with transplant units.

Bayes Theorem↗

Suicide risk prediction by computer interview: a prospective study.

A computer interview program that uses a subjective Bayesian probability model to assess suicide risk was evaluated. Predictions made by clinicians for 52 patients were compared with predictions made by the computer for the same patients. The computer was significantly (p = .001) better at predicting attempters, and clinicians were significantly (p = .01) better at predicting nonattempters. An analysis of receiver operating characteristic curves showed that the computer had better overall discrimination, but the difference was nonsignificant.

Decision Making, Computer-Assisted↗

Clinical inferences and decisions--II. Decision trees, receiver operator curves and subjective probability.

In patient management, clinical decisions follow a logical sequence which can be formally expressed as a decision tree in which the uncertainties associated with each alternative outcome may be made explicit using Bayes' theorem. Where test data is used in the formulation of a decision, the uncertainty associated with the information it conveys may be modified by changing the pass/fail criterion to alter the false positive and false negative error rate. Classical procedures based on information theory are described to illustrate how this may be achieved for any test. When hard data is not available to permit such an approach, the clinician must rely on his own past experience or that of a colleague. Several methods are available for quantifying such experience by estimating subjective probabilities associated with an action or test result. Two simple methods are described for deriving subjective probabilities for subsequent use within a Bayesian decision model.

Bayes Theorem↗

Case-control diagnosis and Bayesian inference in common viral infections.

The predictive values of symptoms and signs for given diseases are often unknown. The fact that a high proportion of individuals with a certain disease may have a specific group of symptoms (the case-control approach) does not necessarily mean that the specific group of symptoms will allow one reliably to diagnose the disease. This study, utilizing a population based data set for common acute infections, shows that descriptions of common viral illnesses found in medical textbooks that associate illnesses with symptoms do not allow one to predict reliably isolation of the supposed causal organism. Positive predictive value of groups of symptoms for specific viral infections did not exceed 11 percent in this study. However, the data closely fitted the Bayesian statistical model often proposed for such decision making by physicians.

Adolescent↗

[The prognostic evaluation of acute pancreatitis].

Early identification of severity is one of the most important problems in acute pancreatitis, both for decision-making and classification. Predictive criteria show a wide range of accuracy: clinical examination (on admission: 76-85%); single laboratory data (PCR: 68-98%, C3-C4: 63-72%); multifactorial scoring systems (Ranson: 65-82%, Imrie: 78-95%); diagnostic peritoneal lavage (72-90%); CT features (52-81%). In 1982 we started a prospective evaluation of the prognostic performances of a bayesian statistical model for the prediction of severe vs mild pancreatis and death vs survival, which uses the outcome-related patterns of several variables, assuming their independence, analysed on a data of 44 patients. The performances have been calculated prospectively by comparing the expected vs actual results on 88 further patients (accuracy, sensitivity and specificity, respectively, in the prediction of severe pancreatitis: 92%, 92%, 93%; in the prediction of death: 95%, 97%, 87%). Moreover, the model can represent classes of risk by combining prediction of death + severe pancreatitis (DSP), survival + severe pancreatitis (SSP) and survival + mild pancreatitis (SMP) (accuracy, sensitivity and specificity, respectively, in the prediction of DSP: 97%, 83%, 100%; in the prediction of SSP: 95%, 87%, 97%; in the prediction of SMP: 95%, 97%, 90%). Our model enables clinicians dealing with other population to re-determine different variables or integrate them with new information, whenever available. It seems to be transferable and adaptable, even with a probable further increase of the performances, without compromising the objectivity of the predictive judgement and the homogeneity of the classes of risk.

Acute Disease↗

Large hierarchical Bayesian analysis of multivariate survival data.

Failure times that are grouped according to shared environments arise commonly in statistical practice. That is, multiple responses may be observed for each of many units. For instance, the units might be patients or centers in a clinical trial setting. Bayesian hierarchical models are appropriate for data analysis in this context. At the first stage of the model, survival times can be modelled via the Cox partial likelihood, using a justification due to Kalbfleisch (1978, Journal of the Royal Statistical Society, Series B 40, 214-221). Thus, questionable parametric assumptions are avoided. Conventional wisdom dictates that it is comparatively safe to make parametric assumptions at subsequent stages. Thus, unit-specific parameters are modelled parametrically. The posterior distribution of parameters given observed data is examined using Markov chain Monte Carlo methods. Specifically, the hybrid Monte Carlo method, as described by Neal (1993a, in Advances in Neural Information Processing 5, 475-482; 1993b, Probabilistic inference using Markov chain Monte Carlo methods), is utilized.

Antineoplastic Combined Chemotherapy Protocols↗

Advances in meta-analysis as a research method.

Meta-analysis is a method of data analysis applied to summarizing research findings, both quantitative and qualitative summaries of individual studies. Rooted in the fundamental values of the scientific enterprise of replicability, causal and correlational analysis, it is useful for answering three general questions: What is the central tendency or typical study outcome? How much variability exists among study outcomes? What is the explanation of the variability? Advanced statistical and mathematical techniques are being used in counting studies with significant and non-significant findings; in combining effect size estimates based on fixed- or random-effects models; in the use of general linear models; and, Bayesian procedures. The methodology of meta-analysis and suggestions for publications are presented as well as appropriate software programs available for use in the meta-analytic process are explored. The benefits of meta-analysis as a research method in effecting health policy development is offered as a pragmatic perspective for future consideration. Conclusions have implications for the use of meta-analysis as a teaching strategy and as a methodology in nursing research and other applied sciences. In view of the rapid pace of knowledge development and increased public demand for accountability, meta-analysis offers an opportunity for organizing phenomena which gives direction for provision of quality health care.

Humans↗

Change-point analysis of neuron spike train data.

In many medical experiments, data are collected across time, over a number of similar trials, or over a number of experimental units. As is the case of neuron spike train studies, these data may be in the form of counts of events per unit of time. These counts may be correlated within each trial. It is often of interest to know if the introduction of an intervention, such as the application of a stimulus, affects the distribution of the counts over the course of the experiment. In such investigations, each trial generates a sequence of data that may or may not contain a change in distribution at some point in time. Each sequence of integer counts can be viewed as arising from a Poisson process and are therefore independently distributed or as an integer-valued time series that allows for correlations between these counts. The main aim of this paper is to show how the ensemble of sample paths may be used to make inference about the distribution of the instantaneous times of change in a given population. This will be accomplished using a Bayesian hierarchical model for these change-points in time. A bonus of these models is they also allow for inference about the probability of a change in each unit and the magnitude of the effects, if any. The use of such change-point models on integer-valued time series is illustrated on neuron spike train data, although the methods can be applied to other situations where integer-valued processes arise.

Action Potentials↗

Bayesian identification of differentially expressed isoforms using a novel joint model of RNA-seq data.

We develop a Bayesian approach, BayesIso, to identify differentially expressed isoforms from RNA-seq data. The approach features a novel joint model of the sample variability and the deferential state of isoforms. Specifically, the within-sample variability and the between-sample variability of each isoform are modeled by a Poisson-Lognormal model and a Gamma-Gamma model, respectively. Using a Bayesian framework, the differential state of each isoform and the model parameters are jointly estimated by a Markov Chain Monte Carlo (MCMC) method. Extensive studies using simulation and real data demonstrate that BayesIso can effectively detect isoforms of less differentially expressed and differential transcripts for genes with multiple isoforms. We applied the approach to breast cancer RNA-seq data and uncovered a unique set of isoforms that form key pathways associated with breast cancer recurrence. First, PI3K/AKT/mTOR signaling and PTEN signaling pathways are identified as being involved in breast cancer development. Further integrated with protein-protein interaction data, pathways of Jak-STAT, mTOR, MAPK and Wnt signaling are revealed in association with breast cancer recurrence. Finally, several pathways are activated in the early recurrence of breast cancer. In tumors that occur early, members of pathways of cellular metabolism and cell cycle (such as CD36 and TOP2A) are upregulated, while immune response genes such as NFATC1 are downregulated.

Humans↗