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In clinical settings, we often face the challenge of building prediction models based on small observational data sets. For example, such a data set might be from a medical center in a multi-center study. Differences between centers might be large, thus requiring specific models based on the data set from the target center. Still, we want to borrow information from the external centers, to deal with small sample sizes. There are approaches that either assign weights to each external data set or each external observation. To incorporate information on differences between data sets and observations, we propose an approach that combines both into weights that can be incorporated into a likelihood for fitting regression models. Specifically, we suggest weights at the data set level that incorporate information on how well the models that provide the observation weights distinguish between data sets. Technically, this takes the form of inverse probability weighting. We explore different scenarios where covariates and outcomes differ among data sets, informing our simulation design for method evaluation. The concept of effective sample size is used for understanding the effectiveness of our subgroup modeling approach. We demonstrate our approach through a clinical application, predicting applied radiotherapy doses for cancer patients. Generally, the proposed approach provides improved prediction performance when external data sets are similar. We thus provide a method for quantifying similarity of external data sets to the target data set and use this similarity to include external observations for improving performance in a target data set prediction modeling task with small data., Comment: minor update of affiliations and funding

In settings requiring synthetic data generation based on a clinical cohort, e.g., due to data protection regulations, heterogeneity across individuals might be a nuisance that we need to control or faithfully preserve. The sources of such heterogeneity might be known, e.g., as indicated by sub-groups labels, or might be unknown and thus reflected only in properties of distributions, such as bimodality or skewness. We investigate how such heterogeneity can be preserved and controlled when obtaining synthetic data from variational autoencoders (VAEs), i.e., a generative deep learning technique that utilizes a low-dimensional latent representation. To faithfully reproduce unknown heterogeneity reflected in marginal distributions, we propose to combine VAEs with pre-transformations. For dealing with known heterogeneity due to sub-groups, we complement VAEs with models for group membership, specifically from propensity score regression. The evaluation is performed with a realistic simulation design that features sub-groups and challenging marginal distributions. The proposed approach faithfully recovers the latter, compared to synthetic data approaches that focus purely on marginal distributions. Propensity scores add complementary information, e.g., when visualized in the latent space, and enable sampling of synthetic data with or without sub-group specific characteristics. We also illustrate the proposed approach with real data from an international stroke trial that exhibits considerable distribution differences between study sites, in addition to bimodality. These results indicate that describing heterogeneity by statistical approaches, such as propensity score regression, might be more generally useful for complementing generative deep learning for obtaining synthetic data that faithfully reflects structure from clinical cohorts.

In a longitudinal clinical registry, different measurement instruments might have been used for assessing individuals at different time points. To combine them, we investigate deep learning techniques for obtaining a joint latent representation, to which the items of different measurement instruments are mapped. This corresponds to domain adaptation, an established concept in computer science for image data. Using the proposed approach as an example, we evaluate the potential of domain adaptation in a longitudinal cohort setting with a rather small number of time points, motivated by an application with different motor function measurement instruments in a registry of spinal muscular atrophy (SMA) patients. There, we model trajectories in the latent representation by ordinary differential equations (ODEs), where person-specific ODE parameters are inferred from baseline characteristics. The goodness of fit and complexity of the ODE solutions then allows to judge the measurement instrument mappings. We subsequently explore how alignment can be improved by incorporating corresponding penalty terms into model fitting. To systematically investigate the effect of differences between measurement instruments, we consider several scenarios based on modified SMA data, including scenarios where a mapping should be feasible in principle and scenarios where no perfect mapping is available. While misalignment increases in more complex scenarios, some structure is still recovered, even if the availability of measurement instruments depends on patient state. A reasonable mapping is feasible also in the more complex real SMA dataset. These results indicate that domain adaptation might be more generally useful in statistical modeling for longitudinal registry data., Comment: 18 pages, 4 figures

When modeling longitudinal biomedical data, often dimensionality reduction as well as dynamic modeling in the resulting latent representation is needed. This can be achieved by artificial neural networks for dimension reduction, and differential equations for dynamic modeling of individual-level trajectories. However, such approaches so far assume that parameters of individual-level dynamics are constant throughout the observation period. Motivated by an application from psychological resilience research, we propose an extension where different sets of differential equation parameters are allowed for observation sub-periods. Still, estimation for intra-individual sub-periods is coupled for being able to fit the model also with a relatively small dataset. We subsequently derive prediction targets from individual dynamic models of resilience in the application. These serve as interpretable resilience-related outcomes, to be predicted from characteristics of individuals, measured at baseline and a follow-up time point, and selecting a small set of important predictors. Our approach is seen to successfully identify individual-level parameters of dynamic models that allows us to stably select predictors, i.e., resilience factors. Furthermore, we can identify those characteristics of individuals that are the most promising for updates at follow-up, which might inform future study design. This underlines the usefulness of our proposed deep dynamic modeling approach with changes in parameters between observation sub-periods.

Synthetic data generation is of great interest in diverse applications, such as for privacy protection. Deep generative models, such as variational autoencoders (VAEs), are a popular approach for creating such synthetic datasets from original data. Despite the success of VAEs, there are limitations when it comes to the bimodal and skewed marginal distributions. These deviate from the unimodal symmetric distributions that are encouraged by the normality assumption typically used for the latent representations in VAEs. While there are extensions that assume other distributions for the latent space, this does not generally increase flexibility for data with many different distributions. Therefore, we propose a novel method, pre-transformation variational autoencoders (PTVAEs), to specifically address bimodal and skewed data, by employing pre-transformations at the level of original variables. Two types of transformations are used to bring the data close to a normal distribution by a separate parameter optimization for each variable in a dataset. We compare the performance of our method with other state-of-the-art methods for synthetic data generation. In addition to the visual comparison, we use a utility measurement for a quantitative evaluation. The results show that the PTVAE approach can outperform others in both bimodal and skewed data generation. Furthermore, the simplicity of the approach makes it usable in combination with other extensions of VAE.

Differentiable programming has recently received much interest as a paradigm that facilitates taking gradients of computer programs. While the corresponding flexible gradient-based optimization approaches so far have been used predominantly for deep learning or enriching the latter with modeling components, we want to demonstrate that they can also be useful for statistical modeling per se, e.g., for quick prototyping when classical maximum likelihood approaches are challenging or not feasible. In an application from a COVID-19 setting, we utilize differentiable programming to quickly build and optimize a flexible prediction model adapted to the data quality challenges at hand. Specifically, we develop a regression model, inspired by delay differential equations, that can bridge temporal gaps of observations in the central German registry of COVID-19 intensive care cases for predicting future demand. With this exemplary modeling challenge, we illustrate how differentiable programming can enable simple gradient-based optimization of the model by automatic differentiation. This allowed us to quickly prototype a model under time pressure that outperforms simpler benchmark models. We thus exemplify the potential of differentiable programming also outside deep learning applications, to provide more options for flexible applied statistical modeling., Comment: 19 pages, 2 figures, 2 tables

Longitudinal biomedical data are often characterized by a sparse time grid and individual-specific development patterns. Specifically, in epidemiological cohort studies and clinical registries we are facing the question of what can be learned from the data in an early phase of the study, when only a baseline characterization and one follow-up measurement are available. Inspired by recent advances that allow to combine deep learning with dynamic modeling, we investigate whether such approaches can be useful for uncovering complex structure, in particular for an extreme small data setting with only two observations time points for each individual. Irregular spacing in time could then be used to gain more information on individual dynamics by leveraging similarity of individuals. We provide a brief overview of how variational autoencoders (VAEs), as a deep learning approach, can be linked to ordinary differential equations (ODEs) for dynamic modeling, and then specifically investigate the feasibility of such an approach that infers individual-specific latent trajectories by including regularity assumptions and individuals' similarity. We also provide a description of this deep learning approach as a filtering task to give a statistical perspective. Using simulated data, we show to what extent the approach can recover individual trajectories from ODE systems with two and four unknown parameters and infer groups of individuals with similar trajectories, and where it breaks down. The results show that such dynamic deep learning approaches can be useful even in extreme small data settings, but need to be carefully adapted., Comment: 23 pages, 7 figures

The research on and application of artificial intelligence (AI) has triggered a comprehensive scientific, economic, social and political discussion. Here we argue that statistics, as an interdisciplinary scientific field, plays a substantial role both for the theoretical and practical understanding of AI and for its future development. Statistics might even be considered a core element of AI. With its specialist knowledge of data evaluation, starting with the precise formulation of the research question and passing through a study design stage on to analysis and interpretation of the results, statistics is a natural partner for other disciplines in teaching, research and practice. This paper aims at contributing to the current discussion by highlighting the relevance of statistical methodology in the context of AI development. In particular, we discuss contributions of statistics to the field of artificial intelligence concerning methodological development, planning and design of studies, assessment of data quality and data collection, differentiation of causality and associations and assessment of uncertainty in results. Moreover, the paper also deals with the equally necessary and meaningful extension of curricula in schools and universities.

Transfer learning refers to the promising idea of initializing model fits based on pre-training on other data. We particularly consider regression modeling settings where parameter estimates from previous data can be used as anchoring points, yet may not be available for all parameters, thus covariance information cannot be reused. A procedure that updates through targeted penalized estimation, which shrinks the estimator towards a nonzero value, is presented. The parameter estimate from the previous data serves as this nonzero value when an update is sought from novel data. This naturally extends to a sequence of data sets with the same response, but potentially only partial overlap in covariates. The iteratively updated regression parameter estimator is shown to be asymptotically unbiased and consistent. The penalty parameter is chosen through constrained cross-validated loglikelihood optimization. The constraint bounds the amount of shrinkage of the updated estimator toward the current one from below. The bound aims to preserve the (updated) estimator's goodness-of-fit on all-but-the-novel data. The proposed approach is compared to other regression modeling procedures. Finally, it is illustrated on an epidemiological study where the data arrive in batches with different covariate-availability and the model is re-fitted with the availability of a novel batch.

Like many groups considering the new programming language Julia, we faced the challenge of accessing the algorithms that we develop in Julia from R. Therefore, we developed the R package JuliaConnectoR, available from the CRAN repository and GitHub (https://github.com/stefan-m-lenz/JuliaConnectoR), in particular for making advanced deep learning tools available. For maintainability and stability, we decided to base communication between R and Julia on TCP, using an optimized binary format for exchanging data. Our package also specifically contains features that allow for a convenient interactive use in R. This makes it easy to develop R extensions with Julia or to simply call functionality from Julia packages in R. Interacting with Julia objects and calling Julia functions becomes user-friendly, as Julia functions and variables are made directly available as objects in the R workspace. We illustrate the further features of our package with code examples, and also discuss advantages over the two alternative packages JuliaCall and XRJulia. Finally, we demonstrate the usage of the package with a more extensive example for employing neural ordinary differential equations, a recent deep learning technique that has received much attention. This example also provides more general guidance for integrating deep learning techniques from Julia into R., Comment: 23 pages, 3 figures, 4 tables

The best way to calculate statistics from medical data is to use the data of individual patients. In some settings, this data is difficult to obtain due to privacy restrictions. In Germany, for example, it is not possible to pool routine data from different hospitals for research purposes without the consent of the patients. The DataSHIELD software provides an infrastructure and a set of statistical methods for joint analyses of distributed data. The contained algorithms are reformulated to work with aggregated data from the participating sites instead of the individual data. If a desired algorithm is not implemented in DataSHIELD or cannot be reformulated in such a way, using artificial data is an alternative. We present a methodology together with a software implementation that builds on DataSHIELD to create artificial data that preserve complex patterns from distributed individual patient data. Such data sets of artificial patients, which are not linked to real patients, can then be used for joint analyses. We use deep Boltzmann machines (DBMs) as generative models for capturing the distribution of data. For the implementation, we employ the package "BoltzmannMachines" from the Julia programming language and wrap it for use with DataSHIELD, which is based on R. As an exemplary application, we conduct a distributed analysis with DBMs on a synthetic data set, which simulates genetic variant data. Patterns from the original data can be recovered in the artificial data using hierarchical clustering of the virtual patients, demonstrating the feasibility of the approach. Our implementation adds to DataSHIELD the ability to generate artificial data that can be used for various analyses, e. g. for pattern recognition with deep learning. This also demonstrates more generally how DataSHIELD can be flexibly extended with advanced algorithms from languages other than R., Comment: 13 pages, 4 figures

Background: State-of-the art selection methods fail to identify weak but cumulative effects of features found in many high-dimensional omics datasets. Nevertheless, these features play an important role in certain diseases. Results: We present Netboost, a three-step dimension reduction technique. First, a boosting-based filter is combined with the topological overlap measure to identify the essential edges of the network. Second, sparse hierarchical clustering is applied on the selected edges to identify modules and finally module information is aggregated by the first principal components. The primary analysis is than carried out on these summary measures instead of the original data. We demonstrate the application of the newly developed Netboost in combination with CoxBoost for survival prediction of DNA methylation and gene expression data from 180 acute myeloid leukemia (AML) patients and show, based on cross-validated prediction error curve estimates, its prediction superiority over variable selection on the full dataset as well as over an alternative clustering approach. The identified signature related to chromatin modifying enzymes was replicated in an independent dataset of AML patients in the phase II AMLSG 12-09 study. In a second application we combine Netboost with Random Forest classification and improve the disease classification error in RNA-sequencing data of Huntington's disease mice. Conclusion: Netboost improves definition of predictive variables for survival analysis and classification. It is a freely available Bioconductor R package for dimension reduction and hypothesis generation in high-dimensional omics applications.

How to select variables and identify functional forms for continuous variables is a key concern when creating a multivariable model. Ad hoc 'traditional' approaches to variable selection have been in use for at least 50 years. Similarly, methods for determining functional forms for continuous variables were first suggested many years ago. More recently, many alternative approaches to address these two challenges have been proposed, but knowledge of their properties and meaningful comparisons between them are scarce. To define a state-of-the-art and to provide evidence-supported guidance to researchers who have only a basic level of statistical knowledge many outstanding issues in multivariable modelling remain. Our main aims are to identify and illustrate such gaps in the literature and present them at a moderate technical level to the wide community of practitioners, researchers and students of statistics. We briefly discuss general issues in building descriptive regression models, strategies for variable selection, different ways of choosing functional forms for continuous variables, and methods for combining the selection of variables and functions. We discuss two examples, taken from the medical literature, to illustrate problems in the practice of modelling. Our overview revealed that there is not yet enough evidence on which to base recommendations for the selection of variables and functional forms in multivariable analysis. Such evidence may come from comparisons between alternative methods. In particular, we highlight seven important topics that require further investigation and make suggestions for the direction of further research.

The discovery of clinical biomarkers requires large patient cohorts and is aided by a pooled data approach across institutions. In many countries, data protection constraints, especially in the clinical environment, forbid the exchange of individual-level data between different research institutes, impeding the conduct of a joint analyses. To circumvent this problem, only non-disclosive aggregated data is exchanged, which is often done manually and requires explicit permission before transfer, i.e., the number of data calls and the amount of data should be limited. This does not allow for more complex tasks such as variable selection, as only simple aggregated summary statistics are typically transferred. Other methods have been proposed that require more complex aggregated data or use input data perturbation, but these methods can either not deal with a high number of biomarkers or lose information. Here, we propose a multivariable regression approach for identifying biomarkers by automatic variable selection based on aggregated data in iterative calls, which can be implemented under data protection constraints. The approach can be used to jointly analyze data distributed across several locations. To minimize the amount of transferred data and the number of calls, we also provide a heuristic variant of the approach. When performing global data standardization, the proposed method yields the same results as pooled individual-level data analysis. In a simulation study, the information loss introduced by local standardization is seen to be minimal. In a typical scenario, the heuristic decreases the number of data calls from more than 10 to 3, rendering manual data releases feasible. To make our approach widely available for application, we provide an implementation of the heuristic version incorporated in the DataSHIELD framework.\

Commercial activity trackers are set to become an essential tool in health research, due to increasing availability in the general population. The corresponding vast amounts of mostly unlabeled data pose a challenge to statistical modeling approaches. To investigate the feasibility of deep learning approaches for unsupervised learning with such data, we examine weekly usage patterns of Fitbit activity trackers with deep Boltzmann machines (DBMs). This method is particularly suitable for modeling complex joint distributions via latent variables. We also chose this specific procedure because it is a generative approach, i.e., artificial samples can be generated to explore the learned structure. We describe how the data can be preprocessed to be compatible with binary DBMs. The results reveal two distinct usage patterns in which one group frequently uses trackers on Mondays and Tuesdays, whereas the other uses trackers during the entire week. This exemplary result shows that DBMs are feasible and can be useful for modeling activity tracker data.