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Thomas F, Bouvier AM, Cariou M, Bouvier V, Jooste V, Pouchucq C, Gardy J, Queneherve L, Launoy G, Alves A, Eid Y, Dejardin O. Influence of non-clinical factors on restorative rectal cancer surgery: An analysis of four specialized population-based digestive cancer registries in France. Dig Liver Dis 2022; 54:258-267. [PMID: 34301489 DOI: 10.1016/j.dld.2021.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/03/2021] [Accepted: 06/24/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study aims to measure the association between deprivation, health care accessibility and health care system with the likelihood of receiving non-restorative rectal cancer surgery (NRRCS). METHODS All adult patients who had rectal resection for invasive adenocarcinoma diagnosed between 2007 and 2016 in four French specialised cancer registries were included. A multilevel logistic regression with random effect was used to assess the link between patient and health care structure characteristics on the probability of NRRCS. RESULTS 2997 patients underwent rectal cancer resection in 68 health care structures: 708 (23.63%) had NRRCS. The likelihood of receiving NRCCS was associated with patients' characteristics (97%): age, sub peritoneal rectal tumors, neoadjuvant therapy, residual tumour and stage III . There was no impact of European Deprivation Index or remoteness on NRRCS. Inter-health care structure variability was modest (3%), of which 50% was explained by the high group volume of colorectal procedures and the type of health care structure which were associated with less NRRCS (p<0.01). CONCLUSION There is an influence of operating volume and type of structure on the probability of NRRCS, but it has truly little importance in explaining differences in performances. The probability of NRRCS is mainly affected by clinical determinant.
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Affiliation(s)
- Flavie Thomas
- Department of Digestive Surgery, University Hospital of Caen, Caen, France; UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France
| | - Anne-Marie Bouvier
- Digestive Cancers Registry of Burgundy, University Hospital Dijon, France; INSERM UMR 1231, University of Burgundy, Dijon, France
| | - Mélanie Cariou
- Finistère Digestive Cancer Registry, University Hospital of Brest, France; EA7479 SPURBO, University of Western Brittany, Brest, France
| | - Véronique Bouvier
- UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France; Department of Research: Epidemiology Research and Evaluation Unit, University Hospital of Caen, Caen, France; Calvados Digestive Cancer Registry, Epidemiology Research and Evaluation Unit, University Hospital of Caen, Caen, France
| | - Valérie Jooste
- Digestive Cancers Registry of Burgundy, University Hospital Dijon, France; INSERM UMR 1231, University of Burgundy, Dijon, France
| | - Camille Pouchucq
- Department of Digestive Surgery, University Hospital of Caen, Caen, France; UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France
| | - Joséphine Gardy
- UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France; Calvados Digestive Cancer Registry, Epidemiology Research and Evaluation Unit, University Hospital of Caen, Caen, France
| | - Lucille Queneherve
- Finistère Digestive Cancer Registry, University Hospital of Brest, France; EA7479 SPURBO, University of Western Brittany, Brest, France; Gastroenterology Department, University Hospital, Brest, France
| | - Guy Launoy
- UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France; Department of Research: Epidemiology Research and Evaluation Unit, University Hospital of Caen, Caen, France; Calvados Digestive Cancer Registry, Epidemiology Research and Evaluation Unit, University Hospital of Caen, Caen, France
| | - Arnaud Alves
- Department of Digestive Surgery, University Hospital of Caen, Caen, France; UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France; Calvados Digestive Cancer Registry, Epidemiology Research and Evaluation Unit, University Hospital of Caen, Caen, France
| | - Yassine Eid
- Department of Digestive Surgery, University Hospital of Caen, Caen, France; UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France
| | - Olivier Dejardin
- UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France; Department of Research: Epidemiology Research and Evaluation Unit, University Hospital of Caen, Caen, France.
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Fournier L, Costaridou L, Bidaut L, Michoux N, Lecouvet FE, de Geus-Oei LF, Boellaard R, Oprea-Lager DE, Obuchowski NA, Caroli A, Kunz WG, Oei EH, O'Connor JPB, Mayerhoefer ME, Franca M, Alberich-Bayarri A, Deroose CM, Loewe C, Manniesing R, Caramella C, Lopci E, Lassau N, Persson A, Achten R, Rosendahl K, Clement O, Kotter E, Golay X, Smits M, Dewey M, Sullivan DC, van der Lugt A, deSouza NM, European Society Of Radiology. Incorporating radiomics into clinical trials: expert consensus endorsed by the European Society of Radiology on considerations for data-driven compared to biologically driven quantitative biomarkers. Eur Radiol 2021; 31:6001-6012. [PMID: 33492473 PMCID: PMC8270834 DOI: 10.1007/s00330-020-07598-8] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/16/2020] [Accepted: 12/03/2020] [Indexed: 02/07/2023]
Abstract
Existing quantitative imaging biomarkers (QIBs) are associated with known biological tissue characteristics and follow a well-understood path of technical, biological and clinical validation before incorporation into clinical trials. In radiomics, novel data-driven processes extract numerous visually imperceptible statistical features from the imaging data with no a priori assumptions on their correlation with biological processes. The selection of relevant features (radiomic signature) and incorporation into clinical trials therefore requires additional considerations to ensure meaningful imaging endpoints. Also, the number of radiomic features tested means that power calculations would result in sample sizes impossible to achieve within clinical trials. This article examines how the process of standardising and validating data-driven imaging biomarkers differs from those based on biological associations. Radiomic signatures are best developed initially on datasets that represent diversity of acquisition protocols as well as diversity of disease and of normal findings, rather than within clinical trials with standardised and optimised protocols as this would risk the selection of radiomic features being linked to the imaging process rather than the pathology. Normalisation through discretisation and feature harmonisation are essential pre-processing steps. Biological correlation may be performed after the technical and clinical validity of a radiomic signature is established, but is not mandatory. Feature selection may be part of discovery within a radiomics-specific trial or represent exploratory endpoints within an established trial; a previously validated radiomic signature may even be used as a primary/secondary endpoint, particularly if associations are demonstrated with specific biological processes and pathways being targeted within clinical trials. KEY POINTS: • Data-driven processes like radiomics risk false discoveries due to high-dimensionality of the dataset compared to sample size, making adequate diversity of the data, cross-validation and external validation essential to mitigate the risks of spurious associations and overfitting. • Use of radiomic signatures within clinical trials requires multistep standardisation of image acquisition, image analysis and data mining processes. • Biological correlation may be established after clinical validation but is not mandatory.
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Affiliation(s)
- Laure Fournier
- PARCC, INSERM, Radiology Department, AP-HP, Hopital europeen Georges Pompidou, Université de Paris, F-75015, Paris, France
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
| | - Lena Costaridou
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- School of Medicine, University of Patras, University Campus, Rio, 26 500, Patras, Greece
| | - Luc Bidaut
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- College of Science, University of Lincoln, Lincoln, LN6 7TS, UK
| | - Nicolas Michoux
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), B-1200, Brussels, Belgium
| | - Frederic E Lecouvet
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), B-1200, Brussels, Belgium
| | - Lioe-Fee de Geus-Oei
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands
| | - Ronald Boellaard
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology & Nuclear Medicine, Cancer Centre Amsterdam, Amsterdam University Medical Centers (VU University), Amsterdam, The Netherlands
- Quantitative Imaging Biomarkers Alliance, Radiological Society of North America, Oak Brook, IL, USA
| | - Daniela E Oprea-Lager
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology & Nuclear Medicine, Cancer Centre Amsterdam, Amsterdam University Medical Centers (VU University), Amsterdam, The Netherlands
| | - Nancy A Obuchowski
- Quantitative Imaging Biomarkers Alliance, Radiological Society of North America, Oak Brook, IL, USA
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Anna Caroli
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Biomedical Engineering, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Wolfgang G Kunz
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Edwin H Oei
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - James P B O'Connor
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Marius E Mayerhoefer
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Manuela Franca
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology, Centro Hospitalar Universitário do Porto, Instituto de Ciências Biomédicas de Abel Salazar, University of Porto, Porto, Portugal
| | - Angel Alberich-Bayarri
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Quantitative Imaging Biomarkers in Medicine (QUIBIM), Valencia, Spain
| | - Christophe M Deroose
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium
- Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Christian Loewe
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Division of Cardiovascular and Interventional Radiology, Dept. for Bioimaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Rashindra Manniesing
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - Caroline Caramella
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Radiology Department, Hôpital Marie Lannelongue, Institut d'Oncologie Thoracique, Université Paris-Saclay, Le Plessis-Robinson, France
| | - Egesta Lopci
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Nuclear Medicine, Humanitas Clinical and Research Hospital - IRCCS, Rozzano, MI, Italy
| | - Nathalie Lassau
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Quantitative Imaging Biomarkers Alliance, Radiological Society of North America, Oak Brook, IL, USA
- Imaging Department, Gustave Roussy Cancer Campus Grand, Paris, UMR 1281, INSERM, CNRS, CEA, Universite Paris-Saclay, Saint-Aubin, France
| | - Anders Persson
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology, and Department of Health, Medicine and Caring Sciences, Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Rik Achten
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology and Medical Imaging, Ghent University Hospital, Gent, Belgium
| | - Karen Rosendahl
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Olivier Clement
- PARCC, INSERM, Radiology Department, AP-HP, Hopital europeen Georges Pompidou, Université de Paris, F-75015, Paris, France
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
| | - Elmar Kotter
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology, University Medical Center Freiburg, Freiburg, Germany
| | - Xavier Golay
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Quantitative Imaging Biomarkers Alliance, Radiological Society of North America, Oak Brook, IL, USA
- Queen Square Institute of Neurology, University College London, London, UK
| | - Marion Smits
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Marc Dewey
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel C Sullivan
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Quantitative Imaging Biomarkers Alliance, Radiological Society of North America, Oak Brook, IL, USA
- Dept. of Radiology, Duke University, 311 Research Dr, Durham, NC, 27710, USA
| | - Aad van der Lugt
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Nandita M deSouza
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria.
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium.
- Quantitative Imaging Biomarkers Alliance, Radiological Society of North America, Oak Brook, IL, USA.
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK.
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8
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Paternoster V, Rajkumar AP, Nyengaard JR, Børglum AD, Grove J, Christensen JH. The importance of data structure in statistical analysis of dendritic spine morphology. J Neurosci Methods 2017; 296:93-98. [PMID: 29287746 DOI: 10.1016/j.jneumeth.2017.12.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/15/2017] [Accepted: 12/24/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Dendritic spine morphology is heterogeneous and highly dynamic. To study the changing or aberrant morphology in test setups, often spines from several neurons from a few experimental units e.g. mice or primary neuronal cultures are measured. This strategy results in a multilevel data structure, which, when not properly addressed, has a high risk of producing false positive and false negative findings. METHODS We used mixed-effects models to deal with data with a multilevel data structure and compared this method to analyses at each level. We apply these statistical tests to a dataset of dendritic spine morphology parameters to illustrate advantages of multilevel mixed-effects model, and disadvantages of other models. RESULTS We present an application of mixed-effects models for analyzing dendritic spine morphology datasets while correcting for the data structure. COMPARISON WITH EXISTING METHODS We further show that analyses at spine level and aggregated levels do not adequately account for the data structure, and that they may lead to erroneous results. CONCLUSION We highlight the importance of data structure in dendritic spine morphology analyses and highly recommend the use of mixed-effects models or other appropriate statistical methods to deal with multilevel datasets. Mixed-effects models are easy to use and superior to commonly used methods by including the data structure and the addition of other explanatory variables, for example sex, and age, etc., as well as interactions between variables or between variables and level identifiers.
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Affiliation(s)
- Veerle Paternoster
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark; Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark; Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark.
| | - Anto P Rajkumar
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark; Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark; Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, & Neuroscience, King's College London, London, United Kingdom; Mental Health of Older Adults and Dementia Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, United Kingdom.
| | - Jens Randel Nyengaard
- Stereology and Electron Microscopy Laboratory, Centre for Stochastic Geometry and Advanced Bioimaging, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
| | - Anders Dupont Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark; Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark.
| | - Jakob Grove
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark; Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark; Bioinformatics Research Centre, BiRC, Aarhus University, Aarhus, Denmark.
| | - Jane Hvarregaard Christensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark; Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark.
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