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Catchment area analysis using bayesian regression modeling.

ABSTRACT: A catchment area (CA) is the geographic area and population from which a cancer center draws patients. Defining a CA allows a cancer center to describe its primary patient population and assess how well it meets the needs of cancer patients within the CA. A CA definition is required for cancer centers applying for National Cancer Institute (NCI)-designated cancer center status. In this research, we constructed both diagnosis and diagnosis/treatment CAs for the Massey Cancer Center (MCC) at Virginia Commonwealth University. We constructed diagnosis CAs for all cancers based on Virginia state cancer registry data and Bayesian hierarchical logistic regression models. We constructed a diagnosis/treatment CA using billing data from MCC and a Bayesian hierarchical Poisson regression model. To define CAs, we used exceedance probabilities for county random effects to assess unusual spatial clustering of patients diagnosed or treated at MCC after adjusting for important demographic covariates. We used the MCC CAs to compare patient characteristics inside and outside the CAs. Among cancer patients living within the MCC CA, patients diagnosed at MCC were more likely to be minority, female, uninsured, or on Medicaid.

SUBMITTER: Wang A

PROVIDER: S-EPMC4403915 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:The adverse outcome pathway (AOP) framework has gained international recognition as a systematic approach linking mechanistic processes to toxicity endpoints. Nevertheless, successful implementation into risk assessments is still limited by the lack of quantitative AOP models (qAOPs) and assessment of uncertainties. The few published qAOP models so far are typically based on data-demanding systems biology models. Here, we propose a less data-demanding approach for quantification of AOPs and AOP networks, based on regression modeling and Bayesian networks (BNs). We demonstrate this approach with the proposed AOP #245, "Uncoupling of photophosphorylation leading to reduced ATP production associated growth inhibition," using a small experimental data set from exposure of Lemna minor to the pesticide 3,5-dichlorophenol. The AOP-BN reflects the network structure of AOP #245 containing 2 molecular initiating events (MIEs), 3 key events (KEs), and 1 adverse outcome (AO). First, for each dose-response and response-response (KE) relationship, we quantify the causal relationship by Bayesian regression modeling. The regression models correspond to dose-response functions commonly applied in ecotoxicology. Secondly, we apply the fitted regression models with associated uncertainty to simulate 10 000 response values along the predictor gradient. Thirdly, we use the simulated values to parameterize the conditional probability tables of the BN model. The quantified AOP-BN model can be run in several directions: 1) prognostic inference, run forward from the stressor node to predict the AO level; 2) diagnostic inference, run backward from the AO node; and 3) omnidirectionally, run from the intermediate MIEs and/or KEs. Internal validation shows that the AOP-BN can obtain a high accuracy rate, when run is from intermediate nodes and when a low resolution is acceptable for the AO. Although the performance of this AOP-BN is limited by the small data set, our study demonstrates a proof-of-concept: the combined use of Bayesian regression modeling and Bayesian network modeling for quantifying AOPs. Integr Environ Assess Manag 2021;17:147-164. © 2020 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

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Catchment area analysis using bayesian regression modeling.

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