Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “predictive modelling”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,495 records · Page 83Linked to original sources

Application of predictive QSAR models to database mining: identification and experimental validation of novel anticonvulsant compounds.

We have developed a drug discovery strategy that employs variable selection quantitative structure-activity relationship (QSAR) models for chemical database mining. The approach starts with the development of rigorously validated QSAR models obtained with the variable selection k nearest neighbor (kNN) method (or, in principle, with any other robust model-building technique). Model validation is based on several statistical criteria, including the randomization of the target property (Y-randomization), independent assessment of the training set model's predictive power using external test sets, and the establishment of the model's applicability domain. All successful models are employed in database mining concurrently; in each case, only variables selected as a result of model building (termed descriptor pharmacophore) are used in chemical similarity searches comparing active compounds of the training set (queries) with those in chemical databases. Specific biological activity (characteristic of the training set compounds) of external database entries found to be within a predefined similarity threshold of the training set molecules is predicted on the basis of the validated QSAR models using the applicability domain criteria. Compounds judged to have high predicted activities by all or the majority of all models are considered as consensus hits. We report on the application of this computational strategy for the first time for the discovery of anticonvulsant agents in the Maybridge and National Cancer Institute (NCI) databases containing ca. 250,000 compounds combined. Forty-eight anticonvulsant agents of the functionalized amino acid (FAA) series were used to build kNN variable selection QSAR models. The 10 best models were applied to mining chemical databases, and 22 compounds were selected as consensus hits. Nine compounds were synthesized and tested at the NIH Epilepsy Branch, Rockville, MD using the same biological test that was employed to assess the anticonvulsant activity of the training set compounds; of these nine, four were exact database hits and five were derived from the hits by minor chemical modifications. Seven of these nine compounds were confirmed to be active, indicating an exceptionally high hit rate. The approach described in this report can be used as a general rational drug discovery tool.

Amides↗

Testing a predictive regression model for response in adult acute myeloid leukemia comparing two induction regimens of the E.O.R.T.C. -AML-5 and AML-6 trial.

Pretreatment characteristics of 295 adults with acute myeloid leukemia who were treated in a large cooperative group of the E.O.R.T.C. between 1976 and 1982 (AML-5) have been evaluated to assess their value as prognostic indicators. Logistic regression methods were applied to derive a model for prediction of achievement of CR. The model was tested prospectively in an independent group of 274 subsequent patients treated with a different but similar induction regimen (AML-6), who were matched in all eligibility criteria. The concordance between the observed percentage of response in the AML-6 trial population and the expected response given by the model built on the AML-5 study was very close for the good response subgroups (WBC less than 50,000/mm3 and age less than 60 yrs), while the discrepancies in the poor prognostic groups were considerable. Furthermore, our study shows that the prognostic value of factors may shift as treatment strategies change and that caution is necessary in applying conclusions from a preceding trial to a current patient population.

Adolescent↗

Maximal inspiratory pressure in elite soccer players.

The respiratory muscle strength of elite athletes has been assessed only for some competitive sports and different conclusions have been reported. The aim of this study was to evaluate the inspiratory muscle strength in a group of professional soccer players in comparison with a group of sedentary subjects. Maximal Inspiratory Pressure (PImax) was measured both at Functional Residual Capacity (FRC) and at Residual Volume (RV) in 130 subjects: 27 of these were elite soccer players (all males, aged 22 +/- 3 years) and 103 were normal sedentary subjects (77 males and 26 females, aged 44 +/- 19 years). Predictive linear models were produced by a stepwise regression analysis in the whole sample of subjects. Both PImaxFRC and PImaxRV models included female gender and ageing as negative predictors, and Body Mass Index (BMI) as positive predictor of the inspiratory pressures. The model predicting PImaxFRC was slightly more accurate than the model predicting PImaxRV (r-squared: 0.38 vs 0.36, respectively). After adjustment for the variables entered in these models, PImaxFRC and PImaxRV were respectively 1.54 KPa and 1.08 KPa higher in soccer players than in sedentary subjects but this result was statistically significant (p < 0.02) only for PImaxFRC. We conclude that the inspiratory muscle strength is increased in soccer players and PImax measured at FRC seems more sensitive in order to discriminate between subjects with different level of physical activity.

Adolescent↗

Predictive QSAR modeling based on diversity sampling of experimental datasets for the training and test set selection.

One of the most important characteristics of Quantitative Structure Activity Relashionships (QSAR) models is their predictive power. The latter can be defined as the ability of a model to predict accurately the target property (e.g., biological activity) of compounds that were not used for model development. We suggest that this goal can be achieved by rational division of an experimental SAR dataset into the training and test set, which are used for model development and validation, respectively. Given that all compounds are represented by points in multidimensional descriptor space, we argue that training and test sets must satisfy the following criteria: (i) Representative points of the test set must be close to those of the training set; (ii) Representative points of the training set must be close to representative points of the test set; (iii) Training set must be diverse. For quantitative description of these criteria, we use molecular dataset diversity indices introduced recently (Golbraikh, A., J. Chem. Inf. Comput. Sci., 40 (2000) 414-425). For rational division of a dataset into the training and test sets, we use three closely related sphere-exclusion algorithms. Using several experimental datasets, we demonstrate that QSAR models built and validated with our approach have statistically better predictive power than models generated with either random or activity ranking based selection of the training and test sets. We suggest that rational approaches to the selection of training and test sets based on diversity principles should be used routinely in all QSAR modeling research.

Algorithms↗

Risk modeling in acute renal failure requiring dialysis: the introduction of a new model.

Predicting patient outcome in acute renal failure has become increasingly important as technology advances and ethical questions arise concerning life supporting therapies. We propose a new model which uses mortality as an endpoint and may be applied to the acute renal failure patient in the ICU setting who requires dialysis. This model is based on our ICU acute renal failure registry and has been prospectively validated for our institution. Our registry for the purposes of developing this model consists of data from 512 ICU patients requiring acute dialysis from 1988 until 1992. The model was developed by testing a variety of potential risk factors for mortality in a univariate analysis (Student's t-test and Chi square), and those factors found to be significant (p < 0.05) were subsequently tested in a multivariate fashion. The factors found significant included male gender, respiratory failure requiring intubation, hematologic dysfunction (platelet count < 50,000, leukocyte count < 2,500, or bleeding diathesis), bilirubin < 2.0 mg/dl, the absence of surgery, serum creatinine on the first dialysis treatment day, an increasing number of failed organ systems, and an increased BUN from the time of admission. Weights are assigned to each variable based on the odds ratio, and a score is generated with a range of 0 to 20. The initial data for the registry demonstrates good fit using the Hosmer and Lemeshow goodness-of-fit table. The model is next validated in 88 patients from 1993 through February 1994, then prospectively tested in 35 additional patients using a standard data collection form, and the model continues to demonstrate good fit. Although this model has been prospectively validated at our institution, this model or any such predictive model should be used with caution if not independently validated at any institution which proposes its use.

Acute Kidney Injury↗

Models developed by three techniques did not achieve acceptable prediction of binary trauma outcomes.

BACKGROUND AND OBJECTIVES: To develop prediction models for outcomes following trauma that met prespecified performance criteria. To compare three methods of developing prediction models: logistic regression, classification trees, and artificial neural networks. METHODS: Models were developed using a 1996-2001 dataset from a major trauma center in Victoria, Australia. Developed models were subjected to external validation using the first year of data collection, 2001-2002, from a state-wide trauma registry for Victoria. Different authors developed models for each method. All authors were blinded to the validation dataset when developing models. RESULTS: Prediction models were developed for an intensive care unit stay following trauma (prevalence 23%) using information collected at the scene of the injury. None of the three methods gave a model that satisfied the performance criteria of sensitivity >80%, positive predictive value >50% in the validation dataset. Prediction models were also developed for death (prevalence 2.9%) using hospital-collected information. The performance criteria of sensitivity >95%, specificity >20% in the validation dataset were not satisfied by any model. CONCLUSION: No statistical method of model development was optimal. Prespecified performance criteria provide useful guides to interpreting the performance of developed models.

Adult↗

A prospective evaluation of the 1-hour decision point for admission versus discharge in acute asthma.

Study objectives were to evaluate the 1-hour decision point for discharge or admission for acute asthma; to compare this decision point to the admission recommendations of the Expert Panel Report 2 (EPR-2) guidelines; to develop a model for predicting need for admission in acute asthma. The design used was a prospective preinterventional and postinterventional comparison. The setting was a university hospital emergency department. Participants included 50 patients seeking care for acute asthma. Patients received standard therapy and were randomized to receive albuterol by nebulizer or metered-dose inhaler with spacer every 20 minutes up to 2 hours. Symptoms, physical examination, spirometry, pulsus paradoxus, medication use, and outcome were evaluated. Based on clinical judgment, the attending physician decided to admit or discharge after 1 hour of therapy. Outcome was compared to the EPR-2 guidelines. Post hoc statistical analyses examined predictors of the need for admission from which a prediction model was developed. Maximal accuracy of the admit versus discharge decision occurred at 1 hour of therapy. Using FEV(1) alone as an outcome predictor yielded suboptimal performance. FEV(1) at 1 hour plus ability to lie flat without dyspnea were the best indicators of response and outcome. A model predictive of the need for admission was developed. It performed better (P =.0054) than the admission algorithm of the EPR-2 guidelines. The decision to admit or discharge acute asthmatics from the ED can be made at 1 hour of therapy. No absolute value of peak flow or FEV(1) reliably predicts need for hospital admission. The EPR-2 guideline thresholds for admission are barely adequate as outcome predictors. A clinical model is proposed that may allow more accurate outcome prediction.

Academic Medical Centers↗

Predictive QSAR modeling based on diversity sampling of experimental datasets for the training and test set selection.

One of the most important characteristics of Quantitative Structure Activity Relashionships (QSAR) models is their predictive power. The latter can be defined as the ability of a model to predict accurately the target property (e.g., biological activity) of compounds that were not used for model development. We suggest that this goal can be achieved by rational division of an experimental SAR dataset into the training and test set, which are used for model development and validation, respectively. Given that all compounds are represented by points in multidimensional descriptor space, we argue that training and test sets must satisfy the following criteria: (i) Representative points of the test set must be close to those of the training set; (ii) Representative points of the training set must be close to representative points of the test set; (iii) Training set must be diverse. For quantitative description of these criteria, we use molecular dataset diversity indices introduced recently (Golbraikh, A., J. Chem. Inf. Comput. Sci., 40 (2000) 414-425). For rational division of a dataset into the training and test sets, we use three closely related sphere-exclusion algorithms. Using several experimental datasets, we demonstrate that QSAR models built and validated with our approach have statistically better predictive power than models generated with either random or activity ranking based selection of the training and test sets. We suggest that rational approaches to the selection of training and test sets based on diversity principles should be used routinely in all QSAR modeling research.

Algorithms↗

Building predictive ADMET models for early decisions in drug discovery.

This review discusses the current challenges facing researchers developing computational models to predict absorption, distribution, metabolism, excretion and toxicity (ADMET) for early drug discovery. The strengths and weaknesses of different modeling approaches are reviewed and a survey of recent strategies to model several key ADMET parameters, including intestinal permeability, blood-brain barrier penetration, metabolism, bioavailability and drug toxicities, is presented.

Biological Availability↗

Development of a model to predict permanent symptomatic postradiosurgery injury for arteriovenous malformation patients. Arteriovenous Malformation Radiosurgery Study Group.

PURPOSE: To better predict permanent complications from arteriovenous malformation (AVM) radiosurgery. METHODS AND MATERIALS: Data from 85 AVM patients who developed symptomatic complications following gamma knife radiosurgery and 337 control patients with no complications were evaluated as part of a multi-institutional study. Of the 85 patients with complications, 38 patients were classified as having permanent symptomatic sequelae (necrosis). AVM marginal doses varied from 10-35 Gy and treatment volumes from 0.26-47.9 cc. Median follow-up for patients without complications was 45 months (range: 24-92). RESULTS: Multivariate analysis of the effects of AVM location and the volume of tissue receiving 12 Gy or more (12-Gy-Volume) allowed construction of a significant postradiosurgery injury expression (SPIE) score. AVM locations in order of increasing risk and SPIE score (from 0-10) were: frontal, temporal, intraventricular, parietal, cerebellar, corpus callosum, occipital, medulla, thalamus, basal ganglia, and pons/midbrain. The final statistical model predicts risks of permanent symptomatic sequelae from SPIE scores and 12-Gy-Volumes. Prior hemorrhage, marginal dose, and Marginal-12-Gy-Volume (target volume excluded) did not significantly improve the risk-prediction model for permanent sequelae (p >/= 0.39). CONCLUSION: The risks of developing permanent symptomatic sequelae from AVM radiosurgery vary dramatically with location and, to a lesser extent, volume. These risks can be predicted according to the SPIE location-risk score and the 12-Gy-Volume.

Case-Control Studies↗

Evaluation of logistic versus linear regression models for predicting pulmonary hypertension syndrome (ascites) using cold exposure or pulmonary artery clamp models in broilers.

Syndromes such as ascites (pulmonary hypertension syndrome) present difficulties both in the interpretation of associated physiological observations and in their analyses. The ability to predict which physiological variables have the greatest influence on survival or, more importantly, which individuals are most susceptible or resistant to ascites would be very useful selection tools. When addressed in this manner, ascites data become binary data sets (healthy or affected). Binary data can be problematic in that they do not meet all of the assumptions necessary for more traditional analyses such as ANOVA and linear regression. Binary data are discrete and do not have normally distributed errors, which violates a fundamental assumption of linear models. The predictive abilities of linear and logistic regression were evaluated in two replicated experiments using two methods to induce ascites, cold exposure (COLD) and surgical clamping of one pulmonary artery (PAC). The logistic and linear predictive models were derived using the same data and variables. The first data set from PAC and COLD were used to develop the predictive models and the replicate data sets of PAC and COLD were used as "test data sets" for the prediction of ascites. The linear models developed were complex, using four or five variables and requiring up to seven different measurements. On average, the linear models predicted ascites correctly 87.6% of the time. The logistic models were simple (single variable) models that predicted ascites correctly 92.0% of the time. The variables used in the logistic models were derivations of the ratio of right ventricular weight to total ventricular weight, either corrected for age or the body weight of the bird. Although linear regression predicted the incidence of ascites almost as well as logistic regression did, logistic regression is the more appropriate test statistic to use.

Analysis of Variance↗

Screening for chemoimmunotherapeutics, success rate and predictivity of models: a five years experience.

While repository adjuvants are already established drugs for antigen specific immunomodulation, no unspecific active immunomodulator has successfully passed clinical trials in tumor patients in western countries yet. As this is in striking contrast to the effects seen with unspecific immunomodulators in experimental immunological and tumor test systems, the value of those screening models to predict clinical success may be asked for. To improve the success rate, it is recommended to test compounds for their immunomodulatory effects as broad as possible in ex vivo and in vivo test systems. Subsequently, the prophylactic as well as therapeutic potency of selected immunomodulating drugs should be evaluated in various models of aptitude, such as chronic infection, autoimmune diseases and chronic inflammatory reactions. Those diseases are at least to a certain extent influenced by the immune system, in contrast to the uncertainty in case of tumor diseases. In a battery of chronic infection models we could find that different chemoimmunotherapeutics with very similar immunopharmacological activity behaved quite differently. Most compounds were ineffective, a part enhanced chronic diseases and only in a few cases a therapeutic effect could be shown. On the other hand, effectivity in protection against the pathogenicity of subsequently applied, selected microorganisms does not predict the therapeutic potency for the same pathogen. Altogether the data show that activation of cells of the immune system by an immunostimulating drug does not predict its therapeutic potency. Moreover, activation of immune cells may also lead to impairness of the immune resistance.

Animals↗

The use of transgenic systems in pharmaceutical research.

Those pharmaceutical companies whose goal is to generate novel innovative drugs are faced with the challenge that only a fraction of the compounds tested in clinical trials eventually become a registered drug. This problem of attrition is compounded by the fact that the clinical trial or development stage is by far the most costly phase of bringing a new drug to market, consuming around 80 per cent of the total spend. Transgenic technology represents an attractive approach to reducing the attrition rate of compounds entering clinical trials by increasing the quality of the target and compound combinations making the transition from discovery into development. Transgenic technology can impact at many points in the discovery process, including target identification and target validation, and provides models designed to alert researchers early to potential problems with drug metabolism and toxicity, as well as providing better models for human diseases. In target identification, transgenic animals harbouring large DNA fragments can be used to narrow down genetic regions. Genetic studies often result in the identification of large genomic regions and one way to decrease the region size is to do complementation studies in transgenic animals using, for example, inserts from bacterial artificial chromosome (BAC) clones. In target validation, transgenic animals can be used for in vivo validation of a specific target. Considerable efforts are being made to establish new, rapid and robust tools with general utility for in vivo validation, but, so far, only transgenic animals work reliably on a wide range of targets. Transgenic animals can also be used to generate better disease models. Predictive animal models to test new compounds and targets will significantly speed up the drug discovery process and, more importantly, increase the quality of the compounds taken further in the research and development process. Humanised transgenic animals harbouring the human target molecule can be used to understand the effect of a compound acting on the human target in vivo. Also, models mimicking human drug metabolism will provide a means of assessing the effect of human-specific metabolites and of understanding the pharmacokinetic properties of potential drugs. In toxicology studies, transgenic animals are providing more predictive models. A good example of this are those models routinely used to look for carcinogenicity associated with new compounds.

Animals↗

Intra- and postoperative predictors of stroke after coronary artery bypass grafting.

BACKGROUND: Stroke is a devastating complication of coronary artery bypass graft surgery. An individual's risk of stroke is based in part on preoperative characteristics but also on intra- and postoperative factors. We developed a risk prediction model for stroke based on factors in intra- and postoperative care, after adjusting for a patient's preoperative risk. METHODS: We conducted a regional prospective study of 11,825 consecutive patients undergoing coronary artery bypass graft surgery surgery from 1996 to 2001. Data were collected on patient and disease characteristics, intra- and postoperative care and course, and outcomes. Stroke was defined as "a new focal neurologic deficit which appears and is still at least partially evident more than 24 hours after its onset." Logistic regression identified significant predictors of stroke. RESULTS: The incidence of stroke was 1.5%. The regression model significantly predicted the occurrence of stroke. As compared with cardiopulmonary bypass for less than 90 minutes, cardiopulmonary bypass for 90 to 113 minutes, odds ratio = 1.59, p = 0.022), cardiopulmonary bypass for 114 minutes or more (odds ratio = 2.36, p < 0.001), atrial fibrillation (odds ratio = 1.82, p < 0.001), and prolonged inotrope use (odds ratio = 2.59, p = 0.001) significantly improved our ability to predict stroke. Nearly 75% of all strokes occurred among the 90% of patients at low or medium preoperative risk. CONCLUSIONS: The inclusion of factors associated with intra- and postoperative care and course significantly improved the prediction model. Most strokes occurred among patients at low or medium preoperative risk, suggesting that many of these strokes may be preventable. Reduction in stroke risk may require modifications in intra- and postoperative care and course.

Age Distribution↗

The relevance of prostatectomy findings for brachytherapy selection in patients with localized prostate carcinoma.

BACKGROUND: The efficacy of brachytherapy for patients with localized prostate carcinoma depends on adequate radiotherapeutic coverage of the primary tumor and its subclinical extraprostatic extensions. Predictive models based on pretherapy factors may be useful to estimate the likelihood for clinically relevant extraprostatic disease and may be incorporated into selection criteria for this procedure. METHODS: Multivariate logistic regression model building was performed using pretherapy factors in 2905 surgically staged patients with localized prostate carcinoma to estimate the probability of seminal vesicle and/or lymph node involvement. Bootstrap methods were employed to assess the stability of the final model parameters and to determine the sensitivity and specificity of the final model. RESULTS: Clinical tumor classification, biopsy Gleason score groupings, and serum prostate specific antigen (PSA) levels were associated with seminal vesicle and/or pelvic lymph node involvement. These factors were incorporated into a multivariate model that predicted for these adverse histopathologic features. Allowing for up to a 10% likelihood for seminal vesicle and/or pelvic lymph node involvement, patients with tumors classified as T1c-T2a, Gleason scores of 2-6, and PSA < or = 16 ng/mL; or with tumors classified as T1c-T2a, Gleason scores of 7-10, and PSA < or = 4 ng/mL; or with tumors classified as T2b-T2c, Gleason scores of 2-6, and PSA < or = 6 ng/mL would be potential candidates for brachytherapy alone. CONCLUSIONS: The predictive model presented may provide criteria whereby an adequately performed prostate brachytherapy procedure is expected to encompass the intraprostatic and adjacent extraprostatic disease. Prostate brachytherapy alone may be considered in these circumstances, whereas the addition of external beam radiotherapy may be reserved for patients with disease that is apt to extend beyond the brachytherapy target volume.

Brachytherapy↗

Environmental and ecological determinants of West Nile virus occurrence in horses in North Dakota, 2002.

West Nile virus (WNV) outbreak in North Dakota in 2002 included over 569 horse cases, clustered mainly in the eastern and northeastern parts of the state. The pattern of occurrence observed suggested existence of specific environmental and ecological factors that increased the risk for infection and illness in those locations. We developed a predictive model with factors that explained the pattern of WNV occurrence observed. Results indicated that surface elevation, temperature, precipitation, reported WNV-positive birds, reported WNV-positive humans, and reported WNV-positive mosquitoes were important predictors of occurrence in horses. However, case distance from water bodies was not significant in the model. Future predictive models of WNV occurrence in horses should take into account these factors in order to improve accuracy and reliability. Research into other potential determinants such as horse management factors are required to determine more differential risk factors associated with WNV occurrence in horses.

Animals↗

ADMET in silico modelling: towards prediction paradise?

Following studies in the late 1990s that indicated that poor pharmacokinetics and toxicity were important causes of costly late-stage failures in drug development, it has become widely appreciated that these areas should be considered as early as possible in the drug discovery process. However, in recent years, combinatorial chemistry and high-throughput screening have significantly increased the number of compounds for which early data on absorption, distribution, metabolism, excretion (ADME) and toxicity (T) are needed, which has in turn driven the development of a variety of medium and high-throughput in vitro ADMET screens. Here, we describe how in silico approaches will further increase our ability to predict and model the most relevant pharmacokinetic, metabolic and toxicity endpoints, thereby accelerating the drug discovery process.

Animals↗

Ethical, legal and organizational issues in the ICU: prediction of outcome.

PURPOSE OF REVIEW: Since the development of the first general outcome prediction models, these instruments have been widely used in the intensive care unit. Last updated in the early 1990s, these models are now severely outdated. RECENT FINDINGS: In recent months, researchers and users assisted in several attempts at improving the existing models through customization or expansion or in the development of new models, such as the Simplified Acute Physiology Score (SAPS) 3 and the Acute Physiology and Chronic Health Evaluation (APACHE) IV. SUMMARY: Although not similar, especially in the choice of the reference population, these models aim at replacing older general outcome models, the predictions from which no longer reflect the current case-mix outcomes of intensive care. The objective of this review is to present and discuss, to the clinician working in the intensive care unit, these different strategies and to give an updated version of the general outcome prediction models available in 2006.

APACHE↗