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Evidence synthesis through a degradation model applied to myocardial infarction

机译:证据合成通过劣化模型施加到心肌梗死

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摘要

We propose an evidence synthesis approach through a degradation model to estimate causal influences of physiological factors on myocardial infarction (MI) and coronary heart disease (CHD). For instance several studies give incidences of MI and CHD for different age strata, other studies give relative or absolute risks for strata of main risk factors of MI or CHD. Evidence synthesis of several studies allows incorporating these disparate pieces of information into a single model. For doing this we need to develop a sufficiently general dynamical model; we also need to estimate the distribution of explanatory factors in the population. We develop a degradation model for both MI and CHD using a Brownian motion with drift, and the drift is modeled as a function of indicators of obesity, lipid profile, inflammation and blood pressure. Conditionally on these factors the times to MI or CHD have inverse Gaussian ( ) distributions. The results we want to fit are generally not conditional on all the factors and thus we need marginal distributions of the time of occurrence of MI and CHD; this leads us to manipulate the inverse Gaussian normal distribution ( ) (an whose drift parameter has a normal distribution). Another possible model arises if a factor modifies the threshold. This led us to define an extension of obtained when both drift and threshold parameters have normal distributions. We applied the model to results published in five important studies of MI and CHD and their risk factors. The fit of the model using the evidence synthesis approach was satisfactory and the effects of the four risk factors were highly significant.
机译:我们提出了一种通过退化模型的证据综合方法,以评估生理因素对心肌梗塞(MI)和冠心病(CHD)的因果影响。例如,有几项研究给出了不同年龄层的MI和CHD发生率,其他研究给出了MI或CHD的主要危险因素的相对或绝对风险。几项研究的证据综合分析可以将这些不同的信息整合到一个模型中。为此,我们需要开发一个足够通用的动力学模型。我们还需要估计人口中解释因素的分布。我们使用带漂移的布朗运动开发了MI和CHD的降解模型,并且将漂移建模为肥胖,脂质分布,炎症和血压指标的函数。在这些因素的条件下,到MI或CHD的时间具有反高斯()分布。我们想要拟合的结果通常并非以所有因素为条件,因此我们需要MI和CHD发生时间的边际分布。这导致我们操纵逆高斯正态分布()(其漂移参数具有正态分布)。如果某个因素修改了阈值,则会出现另一个可能的模型。这导致我们定义了当漂移和阈值参数都具有正态分布时获得的扩展。我们将该模型应用于在MI和CHD及其危险因素的五项重要研究中发表的结果。使用证据综合方法对模型进行拟合是令人满意的,并且四个风险因素的影响都非常显着。

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  • 页码 1–18
  • 总页数 23
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