We focus on Bayesian inference for survival probabilities in a prime-boost vaccination regime in the development of an Ebola vaccine. We are interested in the heterologous prime-boost regimen (unmatched vaccine deliverys using the same antigen) due to its demonstrated durable immunity, well-tolerated safety profile, and suitability as a population vaccination strategy. Our research is motivated by the need to estimate the survival probability given the administered dosage. To do so, we establish two key relationships. Firstly, we model the connection between the designed dose concentration and the induced antibody count using a Bayesian response surface model. Secondly, we model the association between the antibody count and the probability of survival when experimental subjects are exposed to the Ebola virus in a controlled setting using a Bayesian probability of survival model. Finally, we employ a combination of the two models with dose concentration as the predictor of the survival probability for a future vaccinated population. We implement our two-level Bayesian model in Stan, and illustrate its use with simulated and real-world data. Performance of this model is evaluated via simulation. Our work offers a new application of drug synergy models to examine prime-boost vaccine efficacy, and does so using a hierarchical Bayesian framework that allows us to use dose concentration to predict survival probability.
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Commun Stat Theory Methods
March 2024
Division of Biostatistics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, 53226, Wisconsin,USA.
Competing risks data in clinical trial or observational studies often suffer from cluster effects such as center effects and matched pairs design. The proportional subdistribution hazards (PSH) model is one of the most widely used methods for competing risks data analyses. However, the current literature on the PSH model for clustered competing risks data is limited to covariate-independent censoring and the unstratified model.
View Article and Find Full Text PDFCommun Stat Simul Comput
August 2023
Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Observational studies with right-censored data often have clustered data due to matched pairs or a study center effect. In such data, there may be an imbalance in patient characteristics between treatment groups, where Kaplan-Meier curves or unadjusted cumulative incidence curves can be misleading and may not represent the average patient on a given treatment arm. Adjusted curves are desirable to appropriately display survival or cumulative incidence curves in this case.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
June 2023
Division of Cardiac Surgery, MedStar Washington Hospital Center, Washington DC.
Background: The purpose of this study was to evaluate postoperative outcomes with the use of bilateral internal mammary artery (BIMA) conduits in obese patients.
Methods: Between January 2003 and December 2018, 8109 patients underwent isolated coronary artery bypass grafting, including 7218 (89%) treated with single internal mammary artery (SIMA) and 891 (11%) treated with BIMA grafts. Patients were divided into 3 groups according to preoperative body mass index (BMI): normal, BMI <25 kg/m (22.
Ann Thorac Surg Short Rep
March 2024
Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia.
Background: Candidacy for venovenous extracorporeal membrane oxygenation is dictated by ECMO to Rescue Lung Injury in Severe ARDS (EOLIA) criteria. We evaluated the effect of modifying candidacy on the basis of escalating demand and limited resources.
Methods: We retrospectively reviewed adult patients diagnosed with COVID-19-related severe acute respiratory distress syndrome who failed to respond to conventional ventilation and required extracorporeal support at our institution.
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