* A two-stage prediction model for heterogeneous effects of treatments.
- Treatment effects vary across different patients, and estimation of this variability is essential for clinical decision-making. We aimed to develop a model estimating the benefit of alternative treatment options for individual patients, extending a risk modeling approach in a network meta-analysis framework. We propose a two-stage prediction model for heterogeneous treatment effects by combining prognosis research and network meta-analysis methods where individual patient data are available. In the first stage, a prognostic model to predict the baseline risk of the outcome. In the second stage, we use the baseline risk score from the first stage as a single prognostic factor and effect modifier in a network meta-regression model. We apply the approach to a network meta-analysis of three randomized clinical trials comparing the relapses in Natalizumab, Glatiramer Acetate, and Dimethyl Fumarate, including 3590 patients diagnosed with relapsing-remitting multiple sclerosis. We find that the baseline risk score modifies the relative and absolute treatment effects. Several patient characteristics, such as age and disability status, impact the baseline risk of relapse, which in turn moderates the benefit expected for each of the treatments. For high-risk patients, the treatment that minimizes the risk of relapse in 2 years is Natalizumab, whereas Dimethyl Fumarate might be a better option for low-risk patients. Our approach can be easily extended to all outcomes of interest and has the potential to inform a personalized treatment approach.
=>1.損害の恐れ, 危険, 冒険, リスク, 2.危険にさらす, 3.敢えてする, 被保険者, 被保険物, 危険にさらす,
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Overview of noun risk
The noun risk has 4 senses (first 2 from tagged texts)
1. (4) hazard, jeopardy, peril, risk, endangerment -- (a source of danger; a possibility of
incurring loss or misfortune; "drinking alcohol is a health hazard")
2. (2) risk, peril, danger -- (a venture undertaken without regard to possible loss or injury; "he
saw the rewards but not the risks of crime"; "there was a danger he would do the wrong thing")
3. risk, risk of infection -- (the probability of becoming infected given that exposure to an
infectious agent has occurred)
4. risk, risk of exposure -- (the probability of being exposed to an infectious agent)
Overview of verb risk
The verb risk has 2 senses (first 2 from tagged texts)
1. (8) risk, put on the line, lay on the line -- (expose to a chance of loss or damage; "We risked
losing a lot of money in this venture"; "Why risk your life?"; "She laid her job on the line when
she told the boss that he was wrong")
2. (2) gamble, chance, risk, hazard, take chances, adventure, run a risk, take a chance -- (take a
risk in the hope of a favorable outcome; "When you buy these stocks you are gambling")
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