Ability to quantify and predict progression of a disease is fundamental for selecting an appropriate treatment. Many clinical metrics cannot be acquired frequently either because of their cost (e.g. MRI, gait analysis) or because they are inconvenient or harmful to a patient (e.g. biopsy, x-ray). In such scenarios, in order to estimate individual trajectories of disease progression, it is advantageous to leverage similarities between patients, i.e. the covariance of trajectories, and find a latent representation of progression. Most of existing methods for estimating trajectories do not account for events in-between observations, what dramatically decreases their adequacy for clinical practice. In this study, we develop a machine learning framework named Coordinatewise-Soft-Impute (CSI) for analyzing disease progression from sparse observations in the presence of confounding events. CSI is guaranteed to converge to the global minimum of the corresponding optimization problem. Experimental results also demonstrates the effectiveness of CSI using both simulated and real dataset.
In linear mixed-effect model, each trajectory is estimated with @math degrees of freedom, which can still be too complex when observations are sparse. One typical solution is to assume a low-rank structure of the covariance matrix @math by introducing a contraction mapping @math from the functional basis to a low-dimensional latent space. More specifically, one may rewrite the LMM model as where @math is a @math matrix with @math and @math is the new, shorter random effect to be estimated. Methods based on low-rank approximations are widely adopted and applied in practice and different algorithms on fitting the model have been proposed @cite_2 @cite_5 @cite_6 . In the later sections, we will compare our algorithm with one specific implementation named functional-Principle-Component-Analysis (fPCA) @cite_2 , which uses EM algorithm for estimating model parameters and latent variables @math .
@cite_5 @cite_6 @cite_2
2962732961 2091083714
Medical researchers are coming to appreciate that many diseases are in fact complex, heterogeneous syndromes composed of subpopulations that express different variants of a related complication. Longitudinal data extracted from individual electronic health records (EHR) offer an exciting new way to study subtle differences in the way these diseases progress over time. In this paper, we focus on answering two questions that can be asked using these databases of longitudinal EHR data. First, we want to understand whether there are individuals with similar disease trajectories and whether there are a small number of degrees of freedom that account for differences in trajectories across the population. Second, we want to understand how important clinical outcomes are associated with disease trajectories. To answer these questions, we propose the Disease Trajectory Map (DTM), a novel probabilistic model that learns low-dimensional representations of sparse and irregularly sampled longitudinal data. We propose a stochastic variational inference algorithm for learning the DTM that allows the model to scale to large modern medical datasets. To demonstrate the DTM, we analyze data collected on patients with the complex autoimmune disease, scleroderma. We find that DTM learns meaningful representations of disease trajectories and that the representations are significantly associated with important clinical outcomes. SUMMARY The elements of a multivariate data set are often curves rather than single points. Functional principal components can be used to describe the modes of variation of such curves. If one has complete measurements for each individual curve or, as is more common, one has measurements on a fine grid taken at the same time points for all curves, then many standard techniques may be applied. However, curves are often measured at an irregular and sparse set of time points which can differ widely across individuals. We present a technique for handling this more difficult case using a reduced rank mixed effects framework.