A complex adaptive system using statistical learning theory as an inline preprocess for clinical survival analysis

摘要

New advances in medicine have led to a disparity between the existing information about patients and the ability of clinicians to utilize it. Lack of training and incompatibility with clinical techniques has made the use of the complex adaptive systems approach difficult. To avoid this, we used statistical learning theory as an inline preprocess between existing data collection methods and clinical analysis of data. Clinicians would be able to use this system without any changes to their techniques, while improving accuracy. We used data from CT scans of patients with metastatic carcinoma to predict prognosis. Specifically, we used the standard for evaluating response to treatment, RECIST, and new qualitative and quantitative features. An Evolutionary Programming trained Support Vector Machine (EP-SVM), was used to preprocess the data for two traditional survival analysis techniques: Cox Proportional Hazard Models and Kaplan Meier curves. This was compared to Logistic Regression (LR) and using cutoff points. Analyses were also done to compare different inputs and different radiologists. The EP-SVM outperformed both LR and the cutoff method significantly and allowed us to both intelligently combine data from multiple sources and identify the most predictive features without necessitating changes in clinical methods.