Abstract
Multiple Sclerosis (MS) is the most frequent non-traumatic debilitating neurological disease. It is usually diagnosed based on clinical observations and supporting data from auxiliary procedures. However, its course is extremely unpredictable, and traditional statistical survival models fail to perform reliably on longitudinal data. An efficient and precise prognosis model of patient-specific MS time-to-event distributions is needed to aid in joint decision-making in subsequent treatment and care. In this work, we aim to estimate the survival function to predict MS disability progression based on discrete longitudinal reaction time trajectories and related clinical variables. To this end, we initially preprocess two sets of measurements obtained from the same cohort of patients. One set comprises the patients’ reaction trajectories recorded during computerized tests, while the other set involves assessing their disability progression and extracting practical clinical information. Then we propose our deep survival model for discovering the connections between temporal data and the potential risk. The model is optimised over the sum of three losses, including longitudinal loss, survival loss and consistent loss. We evaluate our model against other machine learning methods on the same dataset. The experimental results demonstrate the advantage of our proposed deep learning model and prove that such computerized measurements can genuinely reflect the disease stage of MS patients and provide a second opinion for prognosticating their disability progression.
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Notes
- 1.
Demo website: https://www.msreactor.com/controls/.
References
Bahdanau, D., Cho, K., Bengio, Y.: Neural machine translation by jointly learning to align and translate. arXiv preprint arXiv:1409.0473 (2014)
Cox, D.R.: Regression models and life-tables. J. Roy. Stat. Soc.: Ser. B (Methodol.) 34(2), 187–202 (1972)
Fuh-Ngwa, V., et al.: Developing a clinical-environmental-genotypic prognostic index for relapsing-onset multiple sclerosis and clinically isolated syndrome. Brain Commun. 3(4), fcab288 (2021)
Goldenberg, M.M.: Multiple sclerosis review. Pharm. Therap. 37(3), 175 (2012)
Harrell, F.E., Califf, R.M., Pryor, D.B., Lee, K.L., Rosati, R.A.: Evaluating the yield of medical tests. JAMA 247(18), 2543–2546 (1982)
Hochreiter, S., Schmidhuber, J.: Long short-term memory. Neural Comput. 9(8), 1735–1780 (1997)
Hu, S., Fridgeirsson, E., van Wingen, G., Welling, M.: Transformer-based deep survival analysis. In: Survival Prediction-Algorithms, Challenges and Applications, pp. 132–148. PMLR (2021)
Hunter, S.F., et al.: Confirmed 6-month disability improvement and worsening correlate with long-term disability outcomes in alemtuzumab-treated patients with multiple sclerosis: post hoc analysis of the care-ms studies. Neurol. Therapy 10(2), 803–818 (2021)
Ishwaran, H., Kogalur, U.B., Blackstone, E.H., Lauer, M.S.: Random survival forests. Annal. Appl. Statist. 2(3), 841–860 (2008)
Kane, G.C., Maradit-Kremers, H., Slusser, J.P., Scott, C.G., Frantz, R.P., McGoon, M.D.: Integration of clinical and hemodynamic parameters in the prediction of long-term survival in patients with pulmonary arterial hypertension. Chest 139(6), 1285–1293 (2011)
Katzman, J.L., Shaham, U., Cloninger, A., Bates, J., Jiang, T., Kluger, Y.: Deepsurv: personalized treatment recommender system using a cox proportional hazards deep neural network. BMC Med. Res. Methodol. 18(1), 1–12 (2018)
Kleinbaum, D.G., Klein, M.: Survival Analysis. SBH, Springer, New York (2012). https://doi.org/10.1007/978-1-4419-6646-9
Kurtzke, J.F.: Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33(11), 1444–1444 (1983)
Lee, C., Yoon, J., Van Der Schaar, M.: Dynamic-deephit: a deep learning approach for dynamic survival analysis with competing risks based on longitudinal data. IEEE Trans. Biomed. Eng. 67(1), 122–133 (2019)
Merlo, D., et al.: Association between cognitive trajectories and disability progression in patients with relapsing-remitting multiple sclerosis. Neurology 97(20), e2020–e2031 (2021)
Nagpal, C., Jeanselme, V., Dubrawski, A.: Deep parametric time-to-event regression with time-varying covariates. In: Survival Prediction-Algorithms, Challenges and Applications, pp. 184–193. PMLR (2021)
Nagpal, C., Li, X., Dubrawski, A.: Deep survival machines: fully parametric survival regression and representation learning for censored data with competing risks. IEEE J. Biomed. Health Inform. 25(8), 3163–3175 (2021)
Paszke, A., et al.: Pytorch: an imperative style, high-performance deep learning library. Adv. Neural Inf. Process. Syst. 32 (2019)
Pisani, A.I., Scalfari, A., Crescenzo, F., Romualdi, C., Calabrese, M.: A novel prognostic score to assess the risk of progression in relapsing- remitting multiple sclerosis patients. Eur. J. Neurol. 28(8), 2503–2512 (2021)
Ren, K., et al.: Deep recurrent survival analysis. Proc. AAAI Conf. Artif. Intell. 33, 4798–4805 (2019)
Rudick, R.A., et al.: Disability progression in a clinical trial of relapsing-remitting multiple sclerosis: eight-year follow-up. Arch. Neurol. 67(11), 1329–1335 (2010)
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Zhang, X. et al. (2023). Deep Survival Analysis in Multiple Sclerosis. In: Rekik, I., Adeli, E., Park, S.H., Cintas, C., Zamzmi, G. (eds) Predictive Intelligence in Medicine. PRIME 2023. Lecture Notes in Computer Science, vol 14277. Springer, Cham. https://doi.org/10.1007/978-3-031-46005-0_10
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