An interpretable cluster-based logistic regression model, with application to the characterization of response to therapy in severe eosinophilic asthma
Abstract
Asthma is a disease characterized by chronic airway hyperresponsiveness and inflammation, with signs of variable airflow limitation and impaired lung function leading to respiratory symptoms such as shortness of breath, chest tightness and cough. Eosinophilic asthma is a distinct phenotype that affects more than half of patients diagnosed with severe asthma. It can be effectively treated with monoclonal antibodies targeting specific immunological signaling pathways that fuel the inflammation underlying the disease, particularly Interleukin-5 (IL-5), a cytokine that plays a crucial role in asthma. In this study, we propose a data analysis pipeline aimed at identifying subphenotypes of severe eosinophilic asthma in relation to response to therapy at follow-up, which could have great potential for use in routine clinical practice. Once an optimal partition of patients into subphenotypes has been determined, the labels indicating the group to which each patient has been assigned are used in a novel way. For each input variable in a specialized logistic regression model, a clusterwise effect on response to therapy is determined by an appropriate interaction term between the input variable under consideration and the cluster label. We show that the clusterwise odds ratios can be meaningfully interpreted conditional on the cluster label. In this way, we can define an effect measure for the response variable for each input variable in each of the groups identified by the clustering algorithm, which is not possible in standard logistic regression because the effect of the reference class is aliased with the overall intercept. The interpretability of the model is enforced by promoting sparsity, a goal achieved by learning interactions in a hierarchical manner using a special group-Lasso technique. In addition, valid expressions are provided for computing odds ratios in the unusual parameterization used by the sparsity-promoting algorithm. We show how to apply the proposed data analysis pipeline to the problem of sub-phenotyping asthma patients also in terms of quality of response to therapy with monoclonal antibodies.
Acknowledgment
The authors would like to thank the editor-in-chief and the associate editor as well as two anonymous reviewers for their valuable comments. The manuscript has been thoroughly reviewed and improved with their help and support.
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Research ethics: We performed a retrospective analysis of all patients with SEA who commenced treatment between May 2020 and June 2022 at 12 Italian tertiary referral asthma centers. Informed consent for the retrospective analysis was obtained from all subjects. The involved asthma centers used a shared anonymized database to collect clinical, functional, and biological data. Ethical approval was obtained from each local Ethic Committee (coordinator center: Catania, Italy; document number, 33/2020/PO–14th/April/2020).
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Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved submission.
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Competing interests: The authors declare that are not in any situation which could give rise to a conflict of interest.
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Research funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
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Data availability: The data are available in anonymous form on request due to privacy/ethical restrictions.
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Supplementary Material
This article contains supplementary material (https://doi.org/10.1515/ijb-2023-0061).
© 2024 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Research Articles
- Random forests for survival data: which methods work best and under what conditions?
- Flexible variable selection in the presence of missing data
- An interpretable cluster-based logistic regression model, with application to the characterization of response to therapy in severe eosinophilic asthma
- MBPCA-OS: an exploratory multiblock method for variables of different measurement levels. Application to study the immune response to SARS-CoV-2 infection and vaccination
- Detecting differentially expressed genes from RNA-seq data using fuzzy clustering
- Hypothesis testing for detecting outlier evaluators
- Response to comments on ‘sensitivity of estimands in clinical trials with imperfect compliance’
- Commentary
- Comments on “sensitivity of estimands in clinical trials with imperfect compliance” by Chen and Heitjan
- Research Articles
- Optimizing personalized treatments for targeted patient populations across multiple domains
- Statistical models for assessing agreement for quantitative data with heterogeneous random raters and replicate measurements
- History-restricted marginal structural model and latent class growth analysis of treatment trajectories for a time-dependent outcome
- Revisiting incidence rates comparison under right censorship
- Ensemble learning methods of inference for spatially stratified infectious disease systems
- The survival function NPMLE for combined right-censored and length-biased right-censored failure time data: properties and applications
- Hybrid classical-Bayesian approach to sample size determination for two-arm superiority clinical trials
- Estimation of a decreasing mean residual life based on ranked set sampling with an application to survival analysis
- Improving the mixed model for repeated measures to robustly increase precision in randomized trials
- Bayesian second-order sensitivity of longitudinal inferences to non-ignorability: an application to antidepressant clinical trial data
- A modified rule of three for the one-sided binomial confidence interval
- Kalman filter with impulse noised outliers: a robust sequential algorithm to filter data with a large number of outliers
- Bayesian estimation and prediction for network meta-analysis with contrast-based approach
- Testing for association between ordinal traits and genetic variants in pedigree-structured samples by collapsing and kernel methods
Articles in the same Issue
- Frontmatter
- Research Articles
- Random forests for survival data: which methods work best and under what conditions?
- Flexible variable selection in the presence of missing data
- An interpretable cluster-based logistic regression model, with application to the characterization of response to therapy in severe eosinophilic asthma
- MBPCA-OS: an exploratory multiblock method for variables of different measurement levels. Application to study the immune response to SARS-CoV-2 infection and vaccination
- Detecting differentially expressed genes from RNA-seq data using fuzzy clustering
- Hypothesis testing for detecting outlier evaluators
- Response to comments on ‘sensitivity of estimands in clinical trials with imperfect compliance’
- Commentary
- Comments on “sensitivity of estimands in clinical trials with imperfect compliance” by Chen and Heitjan
- Research Articles
- Optimizing personalized treatments for targeted patient populations across multiple domains
- Statistical models for assessing agreement for quantitative data with heterogeneous random raters and replicate measurements
- History-restricted marginal structural model and latent class growth analysis of treatment trajectories for a time-dependent outcome
- Revisiting incidence rates comparison under right censorship
- Ensemble learning methods of inference for spatially stratified infectious disease systems
- The survival function NPMLE for combined right-censored and length-biased right-censored failure time data: properties and applications
- Hybrid classical-Bayesian approach to sample size determination for two-arm superiority clinical trials
- Estimation of a decreasing mean residual life based on ranked set sampling with an application to survival analysis
- Improving the mixed model for repeated measures to robustly increase precision in randomized trials
- Bayesian second-order sensitivity of longitudinal inferences to non-ignorability: an application to antidepressant clinical trial data
- A modified rule of three for the one-sided binomial confidence interval
- Kalman filter with impulse noised outliers: a robust sequential algorithm to filter data with a large number of outliers
- Bayesian estimation and prediction for network meta-analysis with contrast-based approach
- Testing for association between ordinal traits and genetic variants in pedigree-structured samples by collapsing and kernel methods