Astrid Pechmann

Maren Hackenberg, Astrid Pechmann, Clemens Kreutz et al.

Ordinary differential equations (ODEs) can provide mechanistic models of temporally local changes of processes, where parameters are often informed by external knowledge. While ODEs are popular in systems modeling, they are less established for statistical modeling of longitudinal cohort data, e.g., in a clinical setting. Yet, modeling of local changes could also be attractive for assessing the trajectory of an individual in a cohort in the immediate future given its current status, where ODE parameters could be informed by further characteristics of the individual. However, several hurdles so far limit such use of ODEs, as compared to regression-based function fitting approaches. The potentially higher level of noise in cohort data might be detrimental to ODEs, as the shape of the ODE solution heavily depends on the initial value. In addition, larger numbers of variables multiply such problems and might be difficult to handle for ODEs. To address this, we propose to use each observation in the course of time as the initial value to obtain multiple local ODE solutions and build a combined estimator of the underlying dynamics. Neural networks are used for obtaining a low-dimensional latent space for dynamic modeling from a potentially large number of variables, and for obtaining patient-specific ODE parameters from baseline variables. Simultaneous identification of dynamic models and of a latent space is enabled by recently developed differentiable programming techniques. We illustrate the proposed approach in an application with spinal muscular atrophy patients and a corresponding simulation study. In particular, modeling of local changes in health status at any point in time is contrasted to the interpretation of functions obtained from a global regression. This more generally highlights how different application settings might demand different modeling strategies.

Clemens Schächter, Maren Hackenberg, Michelle Pfaffenlehner et al.

Many rare diseases offer limited established treatment options, leading patients to switch therapies when new medications emerge. To analyze the impact of such treatment switches within the low sample size limitations of rare disease trials, it is important to use all available data sources. This, however, is complicated when usage of measurement instruments change during the observation period, for example when instruments are adapted to specific age ranges. The resulting disjoint longitudinal data trajectories, complicate the application of traditional modeling approaches like mixed-effects regression. We tackle this by mapping observations of each instrument to a aligned low-dimensional temporal trajectory, enabling longitudinal modeling across instruments. Specifically, we employ a set of variational autoencoder architectures to embed item values into a shared latent space for each time point. Temporal disease dynamics and treatment switch effects are then captured through a mixed-effects regression model applied to latent representations. To enable statistical inference, we present a novel statistical testing approach that accounts for the joint parameter estimation of mixed-effects regression and variational autoencoders. The methodology is applied to quantify the impact of treatment switches for patients with spinal muscular atrophy. Here, our approach aligns motor performance items from different measurement instruments for mixed-effects regression and maps estimated effects back to the observed item level to quantify the treatment switch effect. Our approach allows for model selection as well as for assessing effects of treatment switching. The results highlight the potential of modeling in joint latent representations for addressing small data challenges.

Maren Hackenberg, Philipp Harms, Michelle Pfaffenlehner et al.

Longitudinal biomedical data are often characterized by a sparse time grid and individual-specific development patterns. Specifically, in epidemiological cohort studies and clinical registries we are facing the question of what can be learned from the data in an early phase of the study, when only a baseline characterization and one follow-up measurement are available. Inspired by recent advances that allow to combine deep learning with dynamic modeling, we investigate whether such approaches can be useful for uncovering complex structure, in particular for an extreme small data setting with only two observations time points for each individual. Irregular spacing in time could then be used to gain more information on individual dynamics by leveraging similarity of individuals. We provide a brief overview of how variational autoencoders (VAEs), as a deep learning approach, can be linked to ordinary differential equations (ODEs) for dynamic modeling, and then specifically investigate the feasibility of such an approach that infers individual-specific latent trajectories by including regularity assumptions and individuals' similarity. We also provide a description of this deep learning approach as a filtering task to give a statistical perspective. Using simulated data, we show to what extent the approach can recover individual trajectories from ODE systems with two and four unknown parameters and infer groups of individuals with similar trajectories, and where it breaks down. The results show that such dynamic deep learning approaches can be useful even in extreme small data settings, but need to be carefully adapted.