Characterization of uncertainty in the classification of multivariate assays: application to PAM50 centroid-based genomic predictors for breast cancer treatment plans

Journal of Clinical Bioinformatics

Julio C Facelli⁴  Philip S Bernard³  Inge J Stijleman³  Rosalía Caballero¹  Eva Carrasco¹  Miguel Martín⁵  Kenneth M Boucher⁶  Roy RL Bastien²  Mark TW Ebbert² 

[1]Spanish Breast Cancer Research Group, GEICAM, Madrid, Spain

[2]ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA

[3]Department of Pathology, Huntsman Cancer Institute/University of Utah, Salt Lake City, UT, USA

[4]Center for High Performance Computing, University of Utah, Salt Lake City, UT, USA

[5]Department of Medical Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain

[6]Department of Oncological Sciences, University of Utah, Salt Lake City, UT, USA

关键词: Breast Cancer;    Monte Carlo Simulations;    PAM50;    Multivariate Assays;   

Others  :  806157
DOI  :  10.1186/2043-9113-1-37

 received in 2011-10-21, accepted in 2011-12-23,  发布年份 2011

【 摘 要 】

Background

Multivariate assays (MVAs) for assisting clinical decisions are becoming commonly available, but due to complexity, are often considered a high-risk approach. A key concern is that uncertainty on the assay's final results is not well understood. This study focuses on developing a process to characterize error introduced in the MVA's results from the intrinsic error in the laboratory process: sample preparation and measurement of the contributing factors, such as gene expression.

Methods

Using the PAM50 Breast Cancer Intrinsic Classifier, we show how to characterize error within an MVA, and how these errors may affect results reported to clinicians. First we estimated the error distribution for measured factors within the PAM50 assay by performing repeated measures on four archetypal samples representative of the major breast cancer tumor subtypes. Then, using the error distributions and the original archetypal sample data, we used Monte Carlo simulations to generate a sufficient number of simulated samples. The effect of these errors on the PAM50 tumor subtype classification was estimated by measuring subtype reproducibility after classifying all simulated samples. Subtype reproducibility was measured as the percentage of simulated samples classified identically to the parent sample. The simulation was thereafter repeated on a large, independent data set of samples from the GEICAM 9906 clinical trial. Simulated samples from the GEICAM sample set were used to explore a more realistic scenario where, unlike archetypal samples, many samples are not easily classified.

Results

All simulated samples derived from the archetypal samples were classified identically to the parent sample. Subtypes for simulated samples from the GEICAM set were also highly reproducible, but there were a non-negligible number of samples that exhibit significant variability in their classification.

Conclusions

We have developed a general methodology to estimate the effects of intrinsic errors within MVAs. We have applied the method to the PAM50 assay, showing that the PAM50 results are resilient to intrinsic errors within the assay, but also finding that in non-archetypal samples, experimental errors can lead to quite different classification of a tumor. Finally we propose a way to provide the uncertainty information in a usable way for clinicians.

【 授权许可】

   
2011 Ebbert et al; licensee BioMed Central Ltd.

【 图 表 】

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