ABSTRACT
Time-to-event analysis is important in a wide range of applications from clinical prognosis to risk modeling for credit scoring and insurance. In risk modeling, it is sometimes required to make a simultaneous assessment of the hazard arising from two or more mutually exclusive factors. This paper applies to an existing neural network model for competing risks (PLANNCR), a Bayesian regularization with the standard approximation of the evidence to implement automatic relevance determination (PLANNCR-ARD). The theoretical framework for the model is described and its application is illustrated with reference to local and distal recurrence of breast cancer, using the data set of Veronesi (1995).
Subject(s)
Automation/methods , Logistic Models , Neural Networks, Computer , Risk , Adolescent , Adult , Aged , Algorithms , Bayes Theorem , Breast Neoplasms/diagnosis , Computer Simulation , Databases, Factual , Female , Follow-Up Studies , Humans , Middle Aged , Neoplasm Recurrence, Local/diagnosis , Nonlinear Dynamics , Probability , Proportional Hazards Models , Survival Analysis , Time Factors , Young AdultABSTRACT
A three stage development process for the production of a hierarchical rule based prognosis tool is described. The application for this tool is specific to breast cancer patients that have a positive expression of the HER 2 gene. The first stage is the development of a Bayesian classification neural network to classify for cancer specific mortality. Secondly, low-order Boolean rules are extracted form this model using an Orthogonal Search based Rule Extraction (OSRE) algorithm. Further to these rules additional information is gathered from the Kaplan-Meier survival estimates of the population, stratified by the categorizations of the input variables. Finally, expert knowledge is used to further simplify the rules and to rank them hierarchically in the form of a decision tree. The resulting decision tree groups all observations into specific categories by clinical profile and by event rate. The practical clinical value of this decision support tool will in future be tested by external validation with additional data from other clinical centres.