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Investigation of commonly used aortic aneurysm growth rate metrics: Comparing their suitability for clinical and research applications
An aneurysm is a pathological widening of a blood vessel. Aneurysms of the aorta are often asymptomatic until they rupture, killing approximately 10,000 Americans per year. Fortunately, rupture can be prevented through early detection and surgical repair. However, surgical risk outweighs rupture ris...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10420361/ https://www.ncbi.nlm.nih.gov/pubmed/37566584 http://dx.doi.org/10.1371/journal.pone.0289078 |
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author | Abell-Hart, Kayley Hajagos, Janos Garcia, Victor Kaan, James Zhu, Wei Saltz, Mary Saltz, Joel Tassiopoulos, Apostolos |
author_facet | Abell-Hart, Kayley Hajagos, Janos Garcia, Victor Kaan, James Zhu, Wei Saltz, Mary Saltz, Joel Tassiopoulos, Apostolos |
author_sort | Abell-Hart, Kayley |
collection | PubMed |
description | An aneurysm is a pathological widening of a blood vessel. Aneurysms of the aorta are often asymptomatic until they rupture, killing approximately 10,000 Americans per year. Fortunately, rupture can be prevented through early detection and surgical repair. However, surgical risk outweighs rupture risk for small aortic aneurysms, necessitating a policy of surveillance. Understanding the growth rate of aneurysms is essential for determining appropriate surveillance windows. Further, identifying risk factors for fast growth can help identify potential interventions. However, studies in the literature have applied many different methods for defining the growth rate of abdominal aortic aneurysms. It is unclear which of these methods is most accurate and clinically meaningful, and whether these heterogeneous methodologies may have contributed to the varied results reported in the literature. To help future researchers best plan their studies and to help clinicians interpret existing studies, we compared five different models of aneurysmal growth rate. We examined their noise tolerance, temporal bias, predictive accuracy, and statistical power to detect risk factors. We found that hierarchical mixed effects models were more noise tolerant than traditional, unpooled models. We also found that linear models were sensitive to temporal bias, assigning lower growth rates to aneurysms that were detected earlier in their course. Our exponential mixed model was noise-tolerant, resistant to temporal bias, and detected the greatest number of clinical risk factors. We conclude that exponential mixed models may be optimal for large studies. Because our results suggest that choice of method can materially impact a study’s findings, we recommend that future studies clearly state the method used and demonstrate its appropriateness. |
format | Online Article Text |
id | pubmed-10420361 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-104203612023-08-12 Investigation of commonly used aortic aneurysm growth rate metrics: Comparing their suitability for clinical and research applications Abell-Hart, Kayley Hajagos, Janos Garcia, Victor Kaan, James Zhu, Wei Saltz, Mary Saltz, Joel Tassiopoulos, Apostolos PLoS One Research Article An aneurysm is a pathological widening of a blood vessel. Aneurysms of the aorta are often asymptomatic until they rupture, killing approximately 10,000 Americans per year. Fortunately, rupture can be prevented through early detection and surgical repair. However, surgical risk outweighs rupture risk for small aortic aneurysms, necessitating a policy of surveillance. Understanding the growth rate of aneurysms is essential for determining appropriate surveillance windows. Further, identifying risk factors for fast growth can help identify potential interventions. However, studies in the literature have applied many different methods for defining the growth rate of abdominal aortic aneurysms. It is unclear which of these methods is most accurate and clinically meaningful, and whether these heterogeneous methodologies may have contributed to the varied results reported in the literature. To help future researchers best plan their studies and to help clinicians interpret existing studies, we compared five different models of aneurysmal growth rate. We examined their noise tolerance, temporal bias, predictive accuracy, and statistical power to detect risk factors. We found that hierarchical mixed effects models were more noise tolerant than traditional, unpooled models. We also found that linear models were sensitive to temporal bias, assigning lower growth rates to aneurysms that were detected earlier in their course. Our exponential mixed model was noise-tolerant, resistant to temporal bias, and detected the greatest number of clinical risk factors. We conclude that exponential mixed models may be optimal for large studies. Because our results suggest that choice of method can materially impact a study’s findings, we recommend that future studies clearly state the method used and demonstrate its appropriateness. Public Library of Science 2023-08-11 /pmc/articles/PMC10420361/ /pubmed/37566584 http://dx.doi.org/10.1371/journal.pone.0289078 Text en © 2023 Abell-Hart et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Abell-Hart, Kayley Hajagos, Janos Garcia, Victor Kaan, James Zhu, Wei Saltz, Mary Saltz, Joel Tassiopoulos, Apostolos Investigation of commonly used aortic aneurysm growth rate metrics: Comparing their suitability for clinical and research applications |
title | Investigation of commonly used aortic aneurysm growth rate metrics: Comparing their suitability for clinical and research applications |
title_full | Investigation of commonly used aortic aneurysm growth rate metrics: Comparing their suitability for clinical and research applications |
title_fullStr | Investigation of commonly used aortic aneurysm growth rate metrics: Comparing their suitability for clinical and research applications |
title_full_unstemmed | Investigation of commonly used aortic aneurysm growth rate metrics: Comparing their suitability for clinical and research applications |
title_short | Investigation of commonly used aortic aneurysm growth rate metrics: Comparing their suitability for clinical and research applications |
title_sort | investigation of commonly used aortic aneurysm growth rate metrics: comparing their suitability for clinical and research applications |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10420361/ https://www.ncbi.nlm.nih.gov/pubmed/37566584 http://dx.doi.org/10.1371/journal.pone.0289078 |
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