157 research outputs found
Logistic regression has similar performance to optimised machine learning algorithms in a clinical setting: application to the discrimination between type 1 and type 2 diabetes in young adults
This is the final version. Available from the publisher via the DOI in this record.The data that support the findings of this study are available from University
of Exeter Medical School/Oxford University but restrictions apply to the
availability of these data, which were used under license for the current
study, and so are not publicly available. Data are however available from the
authors upon reasonable request and with permission of University of Exeter
Medical School/Oxford University. R code is made available in supplementary
file (see Additional file 2).Background: There is much interest in the use of prognostic and diagnostic prediction models in all areas of
clinical medicine. The use of machine learning to improve prognostic and diagnostic accuracy in this area has been
increasing at the expense of classic statistical models. Previous studies have compared performance between these
two approaches but their findings are inconsistent and many have limitations. We aimed to compare the
discrimination and calibration of seven models built using logistic regression and optimised machine learning
algorithms in a clinical setting, where the number of potential predictors is often limited, and externally validate the
models.
Methods: We trained models using logistic regression and six commonly used machine learning algorithms to
predict if a patient diagnosed with diabetes has type 1 diabetes (versus type 2 diabetes). We used seven predictor
variables (age, BMI, GADA islet-autoantibodies, sex, total cholesterol, HDL cholesterol and triglyceride) using a UK
cohort of adult participants (aged 18–50 years) with clinically diagnosed diabetes recruited from primary and
secondary care (n = 960, 14% with type 1 diabetes). Discrimination performance (ROC AUC), calibration and
decision curve analysis of each approach was compared in a separate external validation dataset (n = 504, 21% with
type 1 diabetes).
Results: Average performance obtained in internal validation was similar in all models (ROC AUC ≥ 0.94). In
external validation, there were very modest reductions in discrimination with AUC ROC remaining ≥ 0.93 for all
methods. Logistic regression had the numerically highest value in external validation (ROC AUC 0.95). Logistic
regression had good performance in terms of calibration and decision curve analysis. Neural network and gradient
boosting machine had the best calibration performance. Both logistic regression and support vector machine had
good decision curve analysis for clinical useful threshold probabilities.
Conclusion: Logistic regression performed as well as optimised machine algorithms to classify patients with type 1
and type 2 diabetes. This study highlights the utility of comparing traditional regression modelling to machine
learning, particularly when using a small number of well understood, strong predictor variables.National Institute for Health Research (NIHR
Interpersonal and affective dimensions of psychopathic traits in adolescents : development and validation of a self-report instrument
We report the development and psychometric evaluations of a self-report instrument designed to screen for psychopathic traits among mainstream community adolescents. Tests of item functioning were initially conducted with 26 adolescents. In a second study the new instrument was administered to 150 high school adolescents, 73 of who had school records of suspension for antisocial behavior. Exploratory factor analysis yielded a 4-factor structure (Impulsivity α = .73, Self-Centredness α = .70, Callous-Unemotional α = .69, and Manipulativeness α = .83). In a third study involving 328 high school adolescents, 130 with records of suspension for antisocial behaviour, competing measurement models were evaluated using confirmatory factor analysis. The superiority of a first-order model represented by four correlated factors that was invariant across gender and age was confirmed. The findings provide researchers and clinicians with a psychometrically strong, self-report instrument and a greater understanding of psychopathic traits in mainstream adolescents
Histological validation of a type 1 diabetes clinical diagnostic model for classification of diabetes
This is the final version. Available on open access from Wiley via the DOI in this recordAims: Misclassification of diabetes is common due to an overlap in the clinical features of type 1 and type 2 diabetes. Combined diagnostic models incorporating clinical and biomarker information have recently been developed that can aid classification, but they have not been validated using pancreatic pathology. We evaluated a clinical diagnostic model against histologically defined type 1 diabetes. Methods: We classified cases from the Network for Pancreatic Organ donors with Diabetes (nPOD) biobank as type 1 (n = 111) or non-type 1 (n = 42) diabetes using histopathology. Type 1 diabetes was defined by lobular loss of insulin-containing islets along with multiple insulin-deficient islets. We assessed the discriminative performance of previously described type 1 diabetes diagnostic models, based on clinical features (age at diagnosis, BMI) and biomarker data [autoantibodies, type 1 diabetes genetic risk score (T1D-GRS)], and singular features for identifying type 1 diabetes by the area under the curve of the receiver operator characteristic (AUC-ROC). Results: Diagnostic models validated well against histologically defined type 1 diabetes. The model combining clinical features, islet autoantibodies and T1D-GRS was strongly discriminative of type 1 diabetes, and performed better than clinical features alone (AUC-ROC 0.97 vs. 0.95; P = 0.03). Histological classification of type 1 diabetes was concordant with serum C-peptide [median < 17 pmol/l (limit of detection) vs. 1037 pmol/l in non-type 1 diabetes; P < 0.0001]. Conclusions: Our study provides robust histological evidence that a clinical diagnostic model, combining clinical features and biomarkers, could improve diabetes classification. Our study also provides reassurance that a C-peptide-based definition of type 1 diabetes is an appropriate surrogate outcome that can be used in large clinical studies where histological definition is impossible. Parts of this study were presented in abstract form at the Network for Pancreatic Organ Donors Conference, Florida, USA, 19–22 February 2019 and Diabetes UK Professional Conference, Liverpool, UK, 6–8 March 2019.Diabetes UKNational Institutes of Health (NIH)National Institute for Health Research (NIHR)JDRFHelmsley Charitable Trus
Impulsivity and self-harm in adolescence: a systematic review
Research supports an association between impulsivity and self-harm, yet inconsistencies in methodology across studies have complicated understanding of this relationship. This systematic review examines the association between impulsivity and self-harm in community-based adolescents aged 11-25 years and aims to integrate findings according to differing concepts and methods. Electronic searches of EMBASE, MEDLINE, PsychINFO, CINAHL, PubMed and The Cochrane Library, and manual searches of reference lists of relevant reviews, identified 4,496 articles published up to July 2015, of which 28 met inclusion criteria. Twenty-four of the studies reported an association between broadly specified impulsivity and self-harm. However, findings varied according to the conception and measurement of impulsivity and the precision with which self-harm behaviours were specified. Specifically, lifetime non-suicidal self-injury was most consistently associated with mood-based impulsivity related traits. However, cognitive facets of impulsivity (relating to difficulties maintaining focus or acting without forethought) differentiated current self-harm from past self-harm. These facets also distinguished those with thoughts of self-harm (ideation) from those who acted on thoughts (enaction). The findings suggested that mood-based impulsivity is related to the initiation of self-harm, while cognitive facets of impulsivity are associated with the maintenance of self-harm. In addition, behavioural impulsivity is most relevant to self-harm under conditions of negative affect. Collectively, the findings indicate that distinct impulsivity facets confer unique risks across the life-course of self-harm. From a clinical perspective, the review suggests that interventions focusing on reducing rash reactivity to emotions or improving self-regulation and decision-making may offer most benefit in supporting those who self-harm
Callous-unemotional traits moderate the relation between prenatal testosterone (2D:4D) and externalising behaviours in children
Children who exhibit callous-unemotional (CU) traits are identified as developing particularly severe forms of externalising behaviours (EB). A number of risk factors have been identified in the development of CU traits, including biological, physiological, and genetic factors. However, prenatal testosterone (PT) remains un-investigated, yet could signal fetal programming of a combination of CU/EB. Using the 2D:4D digit ratio, the current study examined whether CU traits moderated the relationship between PT and EB. Hand scans were obtained from 79 children aged between 5 and 6 years old whose parents completed the parent report ICU (Inventory of Callous Unemotional Traits) and SDQ (Strengths and Difficulties Questionnaire). CU traits were found to moderate the relationship between PT and EB so that children who were exposed to increased PT and were higher in CU traits exhibited more EB. Findings emphasize the importance of recognising that vulnerability for EB that is accompanied by callousness may arise before birth
Open Data from the Third Observing Run of LIGO, Virgo, KAGRA, and GEO
The global network of gravitational-wave observatories now includes five detectors, namely LIGO Hanford, LIGO Livingston, Virgo, KAGRA, and GEO 600. These detectors collected data during their third observing run, O3, composed of three phases: O3a starting in 2019 April and lasting six months, O3b starting in 2019 November and lasting five months, and O3GK starting in 2020 April and lasting two weeks. In this paper we describe these data and various other science products that can be freely accessed through the Gravitational Wave Open Science Center at https://gwosc.org. The main data set, consisting of the gravitational-wave strain time series that contains the astrophysical signals, is released together with supporting data useful for their analysis and documentation, tutorials, as well as analysis software packages
Search for Eccentric Black Hole Coalescences during the Third Observing Run of LIGO and Virgo
Despite the growing number of confident binary black hole coalescences
observed through gravitational waves so far, the astrophysical origin of these
binaries remains uncertain. Orbital eccentricity is one of the clearest tracers
of binary formation channels. Identifying binary eccentricity, however, remains
challenging due to the limited availability of gravitational waveforms that
include effects of eccentricity. Here, we present observational results for a
waveform-independent search sensitive to eccentric black hole coalescences,
covering the third observing run (O3) of the LIGO and Virgo detectors. We
identified no new high-significance candidates beyond those that were already
identified with searches focusing on quasi-circular binaries. We determine the
sensitivity of our search to high-mass (total mass ) binaries
covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to
compare model predictions to search results. Assuming all detections are indeed
quasi-circular, for our fiducial population model, we place an upper limit for
the merger rate density of high-mass binaries with eccentricities at Gpc yr at 90\% confidence level.Comment: 24 pages, 5 figure
Open data from the third observing run of LIGO, Virgo, KAGRA and GEO
The global network of gravitational-wave observatories now includes five
detectors, namely LIGO Hanford, LIGO Livingston, Virgo, KAGRA, and GEO 600.
These detectors collected data during their third observing run, O3, composed
of three phases: O3a starting in April of 2019 and lasting six months, O3b
starting in November of 2019 and lasting five months, and O3GK starting in
April of 2020 and lasting 2 weeks. In this paper we describe these data and
various other science products that can be freely accessed through the
Gravitational Wave Open Science Center at https://gwosc.org. The main dataset,
consisting of the gravitational-wave strain time series that contains the
astrophysical signals, is released together with supporting data useful for
their analysis and documentation, tutorials, as well as analysis software
packages.Comment: 27 pages, 3 figure
Intersectionality of HIV stigma and masculinity in eastern Uganda: implications for involving men in HIV programmes
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