Case-cohort Methods for Survival Data on Families from Routine Registers

In the Nordic countries, there exist several registers containing information on diseases and risk factors for millions of individuals. This information can be linked into families by use of personal identification numbers, and represent a great opportunity for studying diseases that show familial aggregation. Due to the size of the registers, it is difficult to analyze the data by using traditional methods for multivariate survival analysis, such as frailty or copula models. Since the size of the cohort is known, case-cohort methods based on pseudo-likelihoods are suitable for analyzing the data. We present methods for sampling control families both with and without replacement, and with or without stratification. The data are stratified according to family size and covariate values. Depending on the sampling method, results from simulations indicate that one only needs to sample 1%-5% of the control families in order to get good efficiency compared to a traditional cohort analysis. We also provide an application to survival data from the Medical Birth Registry of Norway

DNA copy number motifs are strong and independent predictors of survival in breast cancer.

Somatic copy number alterations are a frequent sign of genome instability in cancer. A precise characterization of the genome architecture would reveal underlying instability mechanisms and provide an instrument for outcome prediction and treatment guidance. Here we show that the local spatial behavior of copy number profiles conveys important information about this architecture. Six filters were defined to characterize regional traits in copy number profiles, and the resulting Copy Aberration Regional Mapping Analysis (CARMA) algorithm was applied to tumors in four breast cancer cohorts (n = 2919). The derived motifs represent a layer of information that complements established molecular classifications of breast cancer. A score reflecting presence or absence of motifs provided a highly significant independent prognostic predictor. Results were consistent between cohorts. The nonsite-specific occurrence of the detected patterns suggests that CARMA captures underlying replication and repair defects and could have a future potential in treatment stratification

Survival prediction from clinico-genomic models - a comparative study

<p>Abstract</p> <p>Background</p> <p>Survival prediction from high-dimensional genomic data is an active field in today's medical research. Most of the proposed prediction methods make use of genomic data alone without considering established clinical covariates that often are available and known to have predictive value. Recent studies suggest that combining clinical and genomic information may improve predictions, but there is a lack of systematic studies on the topic. Also, for the widely used Cox regression model, it is not obvious how to handle such combined models.</p> <p>Results</p> <p>We propose a way to combine classical clinical covariates with genomic data in a clinico-genomic prediction model based on the Cox regression model. The prediction model is obtained by a simultaneous use of both types of covariates, but applying dimension reduction only to the high-dimensional genomic variables. We describe how this can be done for seven well-known prediction methods: variable selection, unsupervised and supervised principal components regression and partial least squares regression, ridge regression, and the lasso. We further perform a systematic comparison of the performance of prediction models using clinical covariates only, genomic data only, or a combination of the two. The comparison is done using three survival data sets containing both clinical information and microarray gene expression data. Matlab code for the clinico-genomic prediction methods is available at <url>http://www.med.uio.no/imb/stat/bmms/software/clinico-genomic/</url>.</p> <p>Conclusions</p> <p>Based on our three data sets, the comparison shows that established clinical covariates will often lead to better predictions than what can be obtained from genomic data alone. In the cases where the genomic models are better than the clinical, ridge regression is used for dimension reduction. We also find that the clinico-genomic models tend to outperform the models based on only genomic data. Further, clinico-genomic models and the use of ridge regression gives for all three data sets better predictions than models based on the clinical covariates alone.</p