Browsing by Subject "Medicine -- Data processing"

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    Flexible models of time-varying exposures
    (2015-05) Wang, Chenkun; Gao, Sujuan; Liu, Hai; Yu, Zhangsheng; Callahan, Christopher M.
    With the availability of electronic medical records, medication dispensing data offers an unprecedented opportunity for researchers to explore complex relationships among longterm medication use, disease progression and potential side-effects in large patient populations. However, these data also pose challenges to existing statistical models because both medication exposure status and its intensity vary over time. This dissertation focused on flexible models to investigate the association between time-varying exposures and different types of outcomes. First, a penalized functional regression model was developed to estimate the effect of time-varying exposures on multivariate longitudinal outcomes. Second, for survival outcomes, a regression spline based model was proposed in the Cox proportional hazards (PH) framework to compare disease risk among different types of time-varying exposures. Finally, a penalized spline based Cox PH model with functional interaction terms was developed to estimate interaction effect between multiple medication classes. Data from a primary care patient cohort are used to illustrate the proposed approaches in determining the association between antidepressant use and various outcomes.
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    Morphometric analysis of hippocampal subfields : segmentation, quantification and surface modeling
    (2014) Cong, Shan; Rizkalla, Maher E.; Shen, Li (Radiologist); Du, Yingzi, 1975-
    Object segmentation, quantification, and shape modeling are important areas inmedical image processing. By combining these techniques, researchers can find valuableways to extract and represent details on user-desired structures, which can functionas the base for subsequent analyses such as feature classification, regression, and prediction. This thesis presents a new framework for building a three-dimensional (3D) hippocampal atlas model with subfield information mapped onto its surface, with which hippocampal surface registration can be done, and the comparison and analysis can be facilitated and easily visualized. This framework combines three powerful tools for automatic subcortical segmentation and 3D surface modeling. Freesurfer and Functional magnetic resonance imaging of the brain's Integrated Registration and Segmentation Tool (FIRST) are employed for hippocampal segmentation and quantification, while SPherical HARMonics (SPHARM) is employed for parametric surface modeling. This pipeline is shown to be effective in creating a hippocampal surface atlas using the Alzheimer's Disease Neuroimaging Initiative Grand Opportunity and phase 2 (ADNI GO/2) dataset. Intra-class Correlation Coefficients (ICCs) are calculated for evaluating the reliability of the extracted hippocampal subfields. The complex folding anatomy of the hippocampus offers many analytical challenges, especially when informative hippocampal subfields are usually ignored in detailed morphometric studies. Thus, current research results are inadequate to accurately characterize hippocampal morphometry and effectively identify hippocampal structural changes related to different conditions. To address this challenge, one contribution of this study is to model the hippocampal surface using a parametric spherical harmonic model, which is a Fourier descriptor for general a 3D surface. The second contribution of this study is to extend hippocampal studies by incorporating valuable hippocampal subfield information. Based on the subfield distributions, a surface atlas is created for both left and right hippocampi. The third contribution is achieved by calculating Fourier coefficients in the parametric space. Based on the coefficient values and user-desired degrees, a pair of averaged hippocampal surface atlas models can be reconstructed. These contributions lay a solid foundation to facilitate a more accurate, subfield-guided morphometric analysis of the hippocampus and have the potential to reveal subtle hippocampal structural damage associated.