Statistical cluster analysis of the British Thoracic Society Severe refractory Asthma Registry: clinical outcomes and phenotype stability.
Statistical cluster analysis of the British Thoracic Society Severe refractory Asthma Registry: clinical outcomes and phenotype stability.
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DOI：
10.1371/journal.pone.0102987
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
British Thoracic Society Severe Refractory Asthma Network
中科院分区：
文献类型：
--
作者：
Newby C;Heaney LG;Menzies-Gow A;Niven RM;Mansur A;Bucknall C;Chaudhuri R;Thompson J;Burton P;Brightling C;British Thoracic Society Severe Refractory Asthma Network
严重难治性哮喘是一种异质性疾病。我们试图确定英国胸科学会严重难治性哮喘登记处的统计聚类，并检查特定聚类的结果和稳定性。采用因子分析和统计聚类建模来确定聚类数量及其成员资格 (N = 349)。中位随访 3 年后评估集群特异性结果。分类器被编程来确定簇稳定性，并在登记处招募的独立新患者队列中进行了验证（n = 245）。确定了五个集群。第1组（34％）是患有早发性疾病的特应性，第2组（21％）是患有迟发性疾病的肥胖，第3组（15％）是患有最不严重的疾病，第4组（15％）是患有迟发性疾病的嗜酸性粒细胞，第5组（15％）有明显的固定气流阻塞。随访时，随着体重指数的增加，所有组中接受口服皮质类固醇治疗的受试者比例均有所增加。聚类 1、聚类 2 和聚类 4 中的恶化频率显着下降，并且与聚类 2 和聚类 4 中外周血嗜酸性粒细胞计数显着下降相关。整个聚类的随访时聚类成员的稳定性为 52%，其中聚类 2 中稳定性最好（71%），聚类 4 中稳定性最差（25%）。在一个独立的验证队列中，分类器识别出具有相似患者分布和特征的相同 5 个簇。统计聚类分析可以识别具有特定结果的不同表型。可以使用分类器来确定簇成员资格，但是当优化处理时，簇稳定性很差。
Severe refractory asthma is a heterogeneous disease. We sought to determine statistical clusters from the British Thoracic Society Severe refractory Asthma Registry and to examine cluster-specific outcomes and stability. Factor analysis and statistical cluster modelling was undertaken to determine the number of clusters and their membership (N = 349). Cluster-specific outcomes were assessed after a median follow-up of 3 years. A classifier was programmed to determine cluster stability and was validated in an independent cohort of new patients recruited to the registry (n = 245). Five clusters were identified. Cluster 1 (34%) were atopic with early onset disease, cluster 2 (21%) were obese with late onset disease, cluster 3 (15%) had the least severe disease, cluster 4 (15%) were the eosinophilic with late onset disease and cluster 5 (15%) had significant fixed airflow obstruction. At follow-up, the proportion of subjects treated with oral corticosteroids increased in all groups with an increase in body mass index. Exacerbation frequency decreased significantly in clusters 1, 2 and 4 and was associated with a significant fall in the peripheral blood eosinophil count in clusters 2 and 4. Stability of cluster membership at follow-up was 52% for the whole group with stability being best in cluster 2 (71%) and worst in cluster 4 (25%). In an independent validation cohort, the classifier identified the same 5 clusters with similar patient distribution and characteristics. Statistical cluster analysis can identify distinct phenotypes with specific outcomes. Cluster membership can be determined using a classifier, but when treatment is optimised, cluster stability is poor.
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影响因子：
10
作者：
Heaney, Liam G.;Brightling, Chris E.;Niven, Rob M.
通讯作者：
Niven, Rob M.
影响因子：
12.4
作者：
Amelink, M.;de Nijs, S. B.;Bel, E. H.
通讯作者：
Bel, E. H.
影响因子：
1.8
作者：
He, Yi;Pan, Wei;Lin, Jizhen
通讯作者：
Lin, Jizhen
影响因子：
5
作者：
Jang, An Soo;Kwon, Hyouk-Soo;Park, Choon Sik
通讯作者：
Park, Choon Sik
影响因子：
6.8
作者：
AKAIKE, H
通讯作者：
AKAIKE, H