Bayesian variable selection based on clinical relevance weights in small sample studies—Application to colon cancer

• Published in: Statistics in medicine Vol. 38; no. 12; pp. 2228 - 2247
• Main Authors: Boulet, Sandrine, Ursino, Moreno, Thall, Peter, Jannot, Anne‐Sophie, Zohar, Sarah
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 30.05.2019; Wiley-Blackwell; John Wiley and Sons Inc
• Subjects: Bayes Theorem; Bayesian analysis; Cancer; clinical relevance weights elicitation; Colonic Neoplasms - drug therapy; Colorectal cancer; Computer Simulation; Decision making; Decision Support Systems, Clinical; Humans; informative priors; Life Sciences; Medical treatment; Methodology; repeated measures; Sample Size; Statistics; Stochastic models; Stochastic Processes; stochastic search variable selection; Within-subjects design; stochastic search variable selection; clinical relevance weights elicitation; informative priors; repeated measures
• ISSN: 0277-6715; 1097-0258; 1097-0258
• DOI: 10.1002/sim.8107

Using clinical data to model the medical decisions behind sequential treatment actions raises methodological challenges. Physicians often have access to many covariates that may be used when making sequential treatment decisions for individual patients. Statistical variable selection methods may help finding which of these variables are used for this decision in everyday practice. When the sample size is not large, Bayesian variable selection methods can address this setting and allow for expert information to be incorporated into prior distributions. Motivated by clinical practice data involving repeated dose adaptation for Irinotecan in colorectal metastatic cancer, we propose a modification of the stochastic search variable selection (SSVS) method, which we call weight‐based SSVS (WBS). We use clinical relevance weights elicited from physician experts to construct prior distributions, with the goal to identify the most influential toxicities and other covariates used for dose adjustment. We evaluate and compare the WBS model performance to the Lasso and SSVS through an extensive simulation study. The simulations show that WBS has better performance and lower rates of false positives and false negatives than the other methods but depends strongly on the covariate weights.