Dissertation/Thesis Abstract

Statistical Support Algorithms for Clinical Decisions and Prevention of Genetic-related Heart Disease
by Sotero, Charity Faith Gallemit, M.S., California State University, Long Beach, 2018, 80; 10751893
Abstract (Summary)

Drug-induced long QT syndrome (diLQTS) can lead to seemingly healthy patients experiencing cardiac arrest, specifically Torsades de Pointes (TdP), which may lead to death. Clinical decision support systems (CDSS) assist better prescribing of drugs, in part by issuing alerts that warn of the drug’s potential harm. LQTS may be either genetic or acquired. Thirteen distinct genetic mutations have already been identified for hereditary LQTS. Since hereditary and acquired LQTS both share similar clinical symptoms, it is reasonable to assume that they both have some sort of genetic component. The goal of this study is to identify genetic risk markers for diLQTS and TdP. These markers will be used to develop a statistical DSS for clinical applications and prevention of genetic-related heart disease. We will use data from a genome-wide associate study conducted by the Pharmacogenomics of Arrhythmia Therapy subgroup of the Pharmacogenetics Research Network, focused on subjects with a history of diLQTS or TdP after taking medication. The data was made available for general research use by National Center for Biotechnology Information (NCBI). The data consists of 831 total patients, with 172 diLQTS and TdP case patients. Out of 620,901 initial markers, variable screening is done by a preliminary t-test (α=0.01), and the resulting feasible set of 5,754 markers associated with diLQTS to prevent TdP were used to create an appropriate predictive model. Methods used to create a predictive model were ensemble logistic regression, elastic net, random forests, artificial neural networks, and linear discriminant analysis. Of these methods using all 5,754 markers, accuracy ranged from 76.84% to 90.29%, with artificial neural networks as the most accurate model. Finally, variable importance algorithms were applied to extract a feasible set of markers from the ensemble logistic regression, elastic net, and random forests methods, and used to produce a subset of genetic markers suitable to build a proposed DSS. Of the methods using a subset of 61 markers, accuracy ranged from 76.59% to 87.00%, with ensemble logistic regression as the most accurate model. Of the methods using a subset of 22 markers, accuracy ranged from 74.24% to 82.87%, with the single hidden layer neural network (using the subset of markers extracted from the ensemble bagged logistic model) as the most accurate model.

Indexing (document details)
Advisor: Moon, Hojin
Commitee: Suaray, Kagba, Zhou, Tianni
School: California State University, Long Beach
Department: Mathematics and Statistics
School Location: United States -- California
Source: MAI 58/01M(E), Masters Abstracts International
Subjects: Statistics
Keywords: Machine learning, Torsades de Pointes
Publication Number: 10751893
ISBN: 9780438257825
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