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Méthodologie de l’utilisation des biomarqueurs quantitatifs longitudinaux pour l’aide à la décision en médecine. Application aux PSA dans le cancer de la prostate

Fabien Subtil 1
1 Biostatistiques santé
Département biostatistiques et modélisation pour la santé et l'environnement [LBBE]
Abstract : For the early diagnosis or prognosis of an event in presence of repeated measurements of a biomarker over time, it is necessary to define a criterion, stemming from the longitudinal profiles of that marker. A method was developed for a robust modelling of marker measurements, to calculate the various criteria for the patients, and compare their diagnostic or prognostic accuracies. Using the continuous criterion as a diagnostic test requires the specification of a threshold. A Bayesian method was developed to estimate this threshold and its credible interval. This method was applied to the diagnosis of local prostate cancer persistence after an ultrasound treatment. The diagnosis relies on serial measurements of prostate specific antigen (PSA), whose nadir (along with several thresholds) was found to be the best diagnostic criterion. This allows to trigger biopsy only when this biopsy is likely to be positive.
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Fabien Subtil. Méthodologie de l’utilisation des biomarqueurs quantitatifs longitudinaux pour l’aide à la décision en médecine. Application aux PSA dans le cancer de la prostate. Applications [stat.AP]. Université Claude Bernard Lyon I, 2010. Français. ⟨tel-01435684⟩

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