Individualized prescriptive inference in ischaemic stroke

Fuente: arXiv
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Auteurs principaux: Giles, Dominic, Foulon, Chris, Pombo, Guilherme, Ruffle, James K., Xu, Tianbo, Jäger, H. Rolf, Cardoso, Jorge, Ourselin, Sebastien, Rees, Geraint, Jha, Ashwani, Nachev, Parashkev
Format: Preprint
Publié: 2023
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author Giles, Dominic
Foulon, Chris
Pombo, Guilherme
Ruffle, James K.
Xu, Tianbo
Jäger, H. Rolf
Cardoso, Jorge
Ourselin, Sebastien
Rees, Geraint
Jha, Ashwani
Nachev, Parashkev
author_facet Giles, Dominic
Foulon, Chris
Pombo, Guilherme
Ruffle, James K.
Xu, Tianbo
Jäger, H. Rolf
Cardoso, Jorge
Ourselin, Sebastien
Rees, Geraint
Jha, Ashwani
Nachev, Parashkev
contents The gold standard in the treatment of ischaemic stroke is set by evidence from randomized controlled trials, based on simple descriptions of presumptively homogeneous populations. Yet the manifest complexity of the brain's functional, connective, and vascular architectures introduces heterogeneities that violate the underlying statistical premisses, potentially leading to substantial errors at both individual and population levels. The counterfactual nature of interventional inference renders quantifying the impact of this defect difficult. Here we conduct a comprehensive series of semi-synthetic, biologically plausible, virtual interventional trials across 100M+ distinct simulations. We generate empirically grounded virtual trial data from large-scale meta-analytic connective, functional, genetic expression, and receptor distribution data, with high-resolution maps of 4K+ acute ischaemic lesions. Within each trial, we estimate treatment effects using models varying in complexity, in the presence of increasingly confounded outcomes and noisy treatment responses. Individualized prescriptions inferred from simple models, fitted to unconfounded data, were less accurate than those from complex models, fitted to confounded data. Our results indicate that complex modelling with richly represented lesion data is critical to individualized prescriptive inference in ischaemic stroke.
format Preprint
id arxiv_https___arxiv_org_abs_2301_10748
institution arXiv
publishDate 2023
record_format arxiv
spellingShingle Individualized prescriptive inference in ischaemic stroke
Giles, Dominic
Foulon, Chris
Pombo, Guilherme
Ruffle, James K.
Xu, Tianbo
Jäger, H. Rolf
Cardoso, Jorge
Ourselin, Sebastien
Rees, Geraint
Jha, Ashwani
Nachev, Parashkev
Quantitative Methods
The gold standard in the treatment of ischaemic stroke is set by evidence from randomized controlled trials, based on simple descriptions of presumptively homogeneous populations. Yet the manifest complexity of the brain's functional, connective, and vascular architectures introduces heterogeneities that violate the underlying statistical premisses, potentially leading to substantial errors at both individual and population levels. The counterfactual nature of interventional inference renders quantifying the impact of this defect difficult. Here we conduct a comprehensive series of semi-synthetic, biologically plausible, virtual interventional trials across 100M+ distinct simulations. We generate empirically grounded virtual trial data from large-scale meta-analytic connective, functional, genetic expression, and receptor distribution data, with high-resolution maps of 4K+ acute ischaemic lesions. Within each trial, we estimate treatment effects using models varying in complexity, in the presence of increasingly confounded outcomes and noisy treatment responses. Individualized prescriptions inferred from simple models, fitted to unconfounded data, were less accurate than those from complex models, fitted to confounded data. Our results indicate that complex modelling with richly represented lesion data is critical to individualized prescriptive inference in ischaemic stroke.
title Individualized prescriptive inference in ischaemic stroke
topic Quantitative Methods
url https://arxiv.org/abs/2301.10748