Integrating joint latent class mixed models and Bayesian network for uncovering clinical subgroups of COVID-19 patients

Author:

Cugnata Federica1,Brombin Chiara1,Cippà Pietro E.23,Ceschi Alessandro3456,Ferrari Paolo247,Di Serio Clelia16

Affiliation:

1. University Centre for Statistics in the Biomedical Sciences (CUSSB) and School of Psychology, Vita-Salute San Raffaele University, Milan, Italy

2. Department of Medicine, Division of Nephrology, Ente Ospedaliero Cantonale, Bellinzona, Switzerland

3. Faculty of Medicine, University of Zurich, Zurich, Switzerland

4. Biomedical Faculty, Università della Svizzera Italiana, Lugano, Switzerland

5. Institute of Pharmacology and Toxicology, Ente Ospedaliero Cantonale, Bellinzona, Switzerland

6. Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, Zurich, Switzerland

7. Clinical School, University of New South Wales, Sydney, New South Wales, Australia

Abstract

When modelling the dynamics of biomarkers in biomedical studies, it is essential to identify homogeneous clusters of patients and analyse them from a precision medicine perspective. This need has emerged as crucial and urgent during the COVID-19 pandemic: early understanding of symptoms and patient heterogeneity has significant implications for prevention, early diagnosis, effective management, and treatment. Additionally, biomarker progression may be associated with clinically relevant time-toevent data. Therefore, statistical models are necessary to gain insight into complex disease mechanisms by properly accounting for unobservable heterogeneity in patients while jointly modelling longitudinal and time-to-event data. In this study, we leverage the key features of Latent Class modelling and Bayesian Network approaches and propose a unified framework to (a) uncover homogeneous subgroups of patients concerning their longitudinal and survival data and (b) describe patient subgroups within a multivariate framework.

Publisher

SAGE Publications

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