In a clinical trial, the random allocation aims to balance prognostic factors between arms, preventing true confounders. However, residual differences due to chance may introduce near-confounders. Adjusting on prognostic factors is therefore recommended, especially because the related increase of the power. In this paper, we hypothesized that G-computation associated with machine learning could be a suitable method for randomized clinical trials even with small sample sizes. It allows for flexible estimation of the outcome model, even when the covariates' relationships with outcomes are complex. Through simulations, penalized regressions (Lasso, Elasticnet) and algorithm-based methods (neural network, support vector machine, super learner) were compared. Penalized regressions reduced variance but may introduce a slight increase in bias. The associated reductions in sample size ranged from 17\% to 54\%. In contrast, algorithm-based methods, while effective for larger and more complex data structures, underestimated the standard deviation, especially with small sample sizes. In conclusion, G-computation with penalized models, particularly Elasticnet with splines when appropriate, represents a relevant approach for increasing the power of RCTs and accounting for potential near-confounders.

Breast cancer prognosis is crucial for effective treatment, with the disease more common in women over 40 years old but rare under 40 years old, where less than 5 percent of cases occur in the U.S. Studies indicate a worse prognosis in younger women, which varies by ethnicity. Breast cancers are classified based on receptors like estrogen, progesterone, and HER2. Triple-negative breast cancer (TNBC), lacking these receptors, accounts for about 15 percent of cases and is more prevalent in younger patients, often resulting in poorer outcomes. Nevertheless, the impact of age on TNBC prognosis remains unclear. Factors like age, race, tumor grade, size, and lymph node status are studied for their role in TNBC's clinical outcomes, but current research is inconclusive about age-related differences. This study uses SEER data set to examine the influence of younger age on survivability in TNBC patients, aiming to determine if age is a significant prognostic factor. Our experimental results on SEER dataset confirm the existing research reports that TNBC patients have worse prognosis compared to non-TNBC based on age. Our main goal was to investigate whether younger age has any significance on the survivability of TNBC patients. Experimental results do not show that younger age has any significance on the prognosis and survival rate of the TNBC patients

Tongue cancer is a common oral cavity malignancy that originates in the mouth and throat. Much effort has been invested in improving its diagnosis, treatment, and management. Surgical removal, chemotherapy, and radiation therapy remain the major treatment for tongue cancer. The survival of patients determines the treatment effect. Previous studies have identified certain survival and risk factors based on descriptive statistics, ignoring the complex, nonlinear relationship among clinical and demographic variables. In this study, we utilize five cutting-edge machine learning models and clinical data to predict the survival of tongue cancer patients after treatment. Five-fold cross-validation, bootstrap analysis, and permutation feature importance are applied to estimate and interpret model performance. The prognostic factors identified by our method are consistent with previous clinical studies. Our method is accurate, interpretable, and thus useable as additional evidence in tongue cancer treatment and management.

Personalized diagnoses have not been possible due to sear amount of data pathologists have to bear during the day-to-day routine. This lead to the current generalized standards that are being continuously updated as new findings are reported. It is noticeable that these effective standards are developed based on a multi-source heterogeneous data, including whole-slide images and pathology and clinical reports. In this study, we propose a framework that combines pathological images and medical reports to generate a personalized diagnosis result for individual patient. We use nuclei-level image feature similarity and content-based deep learning method to search for a personalized group of population with similar pathological characteristics, extract structured prognostic information from descriptive pathology reports of the similar patient population, and assign importance of different prognostic factors to generate a personalized pathological diagnosis result. We use multi-source heterogeneous data from TCGA (The Cancer Genome Atlas) database. The result demonstrate that our framework matches the performance of pathologists in the diagnosis of renal cell carcinoma. This framework is designed to be generic, thus could be applied for other types of cancer. The weights could provide insights to the known prognostic factors and further guide more precise clinical treatment protocols.

The COVID-19 corona virus has claimed 4.1 million lives, as of July 24, 2021. A variety of machine learning models have been applied to related data to predict important factors such as the severity of the disease, infection rate and discover important prognostic factors. Often the usefulness of the findings from the use of these techniques is reduced due to lack of method interpretability. Some recent progress made on the interpretability of machine learning models has the potential to unravel more insights while using conventional machine learning models. In this work, we analyze COVID-19 blood work data with some of the popular machine learning models; then we employ state-of-the-art post-hoc local interpretability techniques(e.g.- SHAP, LIME), and global interpretability techniques(e.g. - symbolic metamodeling) to the trained black-box models to draw interpretable conclusions. In the gamut of machine learning algorithms, regressions remain one of the simplest and most explainable models with clear mathematical formulation. We explore one of the most recent techniques called symbolic metamodeling to find the mathematical expression of the machine learning models for COVID-19. We identify Acute Kidney Injury (AKI), initial Albumin level (ALBI), Aspartate aminotransferase (ASTI), Total Bilirubin initial(TBILI) and D-Dimer initial (DIMER) as major prognostic factors of the disease severity. Our contributions are- (i) uncover the underlying mathematical expression for the black-box models on COVID-19 severity prediction task (ii) we are the first to apply symbolic metamodeling to this task, and (iii) discover important features and feature interactions.

Survival prediction is crucial to healthcare research, but is confined primarily to specific types of data involving only the present measurements. This paper considers the more general class of healthcare data found in practice, which includes a wealth of intermittently varying historical measurements in addition to the present measurements. Making survival predictions on such data bristles with challenges to the existing prediction models. For this reason, we propose a new semi-proportional hazards model using locally time-varying coefficients, and a novel complete-data model learning criterion for coefficient optimization. Experiments on the healthcare data demonstrate the effectiveness and generalizability of our model and its promise in practical applications.

The TNM staging system has been used since the early 1960's to predict breast cancer patient outcome. In an attempt to increase prognostic accuracy, many putative prognostic factors have been identified. Because the TNM stage model can not accommodate these new factors, the proliferation of factors in breast cancer has lead to clinical confusion. What is required is a new computerized prognostic system that can test putative prognostic factors and integrate the predictive factors with the TNM variables in order to increase prognostic accuracy. Using the area under the curve of the receiver operating characteristic, we compare the accuracy of the following predictive models in terms of five year breast cancer-specific survival: pTNM staging system, principal component analysis, classification and regression trees, logistic regression, cascade correlation neural network, conjugate gradient descent neural, probabilistic neural network, and backpropagation neural network. Several statistical models are significantly more ac- 1064 Harry B. Burke, David B. Rosen, Philip H. Goodman

The TNM staging system has been used since the early 1960's to predict breast cancer patient outcome. In an attempt to increase prognostic accuracy, many putative prognostic factors have been identified. Because the TNM stage model can not accommodate these new factors, the proliferation of factors in breast cancer has lead to clinical confusion. What is required is a new computerized prognostic system that can test putative prognostic factors and integrate the predictive factors with the TNM variables in order to increase prognostic accuracy. Using the area under the curve of the receiver operating characteristic, we compare the accuracy of the following predictive models in terms of five year breast cancer-specific survival: pTNM staging system, principal component analysis, classification and regression trees, logistic regression, cascade correlation neural network, conjugate gradient descent neural, probabilistic neural network, and backpropagation neural network. Several statistical models are significantly more ac- 1064 Harry B. Burke, David B. Rosen, Philip H. Goodman

The TNM staging system has been used since the early 1960's to predict breast cancer patient outcome. In an attempt to increase prognosticaccuracy, many putative prognostic factors have been identified. Because the TNM stage model can not accommodate thesenew factors, the proliferation of factors in breast cancer has lead to clinical confusion. What is required is a new computerized prognostic system that can test putative prognostic factors and integrate the predictive factors with the TNM variables inorder to increase prognostic accuracy. Using the area under the curve of the receiver operating characteristic, we compare the accuracy of the following predictive models in terms of five year breast cancer-specific survival: pTNM staging system, principal componentanalysis, classification and regression trees, logistic regression, cascade correlation neural network, conjugate gradient descent neural, probabilistic neural network, and backpropagation neural network. Several statistical models are significantly more ac- 1064 HarryB.