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Modeling and Inference for Real-World Health Data: Addressing Complex Trajectories, Missingness, and Unstructured Text
Modeling and Inference for Real-World Health Data: Addressing Complex Trajectories, Missin...
Modeling and Inference for Real-World Health Data: Addressing Complex Trajectories, Missingness, and Unstructured Text

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자료유형  
 학위논문 서양
최종처리일시  
20260202105307
ISBN  
9798270289409
DDC  
574
저자명  
Qu, Yixiang.
서명/저자  
Modeling and Inference for Real-World Health Data: Addressing Complex Trajectories, Missingness, and Unstructured Text
발행사항  
[Sl] : The University of North Carolina at Chapel Hill, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
153 p
주기사항  
Source: Dissertations Abstracts International, Volume: 87-07, Section: B.
주기사항  
Advisor: Wu, Di;Ibrahim, Joseph G.
학위논문주기  
Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2025.
초록/해제  
요약The proliferation of complex, high-dimensional, and longitudinal data from sources like clinical trials and Electronic Health Records (EHRs) presents significant analytical challenges. Standard analytical methods are often insufficient, as their underlying assumptions fail to capture the nuanced dynamics of non-linear disease progression, complex microbial ecosystems, and unstructured clinical text. This dissertation addresses these limitations by developing and validating three novel computational frameworks, each tailored to the unique complexities of oncology clinical trials, longitudinal microbiome studies, and unstructured EHR analysis, respectively.The first project introduces a cure rate joint model for analyzing longitudinal tumor burden and time-to-event data in oncology. Addressing limitations in capturing non-linear treatment responses, this model integrates a random change-point structure to capture tumor shrinkage and regrowth, alongside a cure-rate component for long-term control. A primary innovation is leveraging survival data to constrain the change point's timing, ensuring regrowth precedes observed progression. Applied to a non-small cell lung cancer trial, this framework yields accurate treatment effect estimations and deeper insight into disease dynamics.The second project addresses irregularly-sampled data in longitudinal microbiome studies by proposing the Bidirectional GRU-ODE-Bayes (BGOB) model. This deep-learning framework uses Neural Ordinary Differential Equations (ODE) to learn continuous-time trajectories from sparse observations. By processing time-series bidirectionally, BGOB accurately interpolates missing time points and unobserved biological zeros to create complete data matrices. Applications to early childhood caries and inflammatory bowel disease cohorts demonstrate that BGOB significantly improves the statistical power of downstream analyses, such as differential abundance testing and clustering.The third project introduces precLLM, a framework enabling smaller, locally-deployed Large Language Models (LLMs) for unstructured EHR analysis to address privacy and cost barriers. The core innovation is a smart preprocessing step that filters long clinical notes to isolate relevant text before inference. Evaluations on private and public EHR datasets show that this preprocessing enhances the accuracy of smaller models for clinical phenotyping, often outperforming much larger models and proving more efficient than fine-tuning with limited data. We also discuss its potential for enabling more complex longitudinal analyses of patient trajectories within EHR data.
일반주제명  
Biostatistics
일반주제명  
Medicine
일반주제명  
Bioinformatics
일반주제명  
Clinical psychology
키워드  
Electronic Health Records
키워드  
EHR analysis
키워드  
Clinical trials
키워드  
Longitudinal microbiome studies
기타저자  
The University of North Carolina at Chapel Hill Biostatistics
기본자료저록  
Dissertations Abstracts International. 87-07B.
전자적 위치 및 접속  
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MARC

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■1001  ▼aQu,  Yixiang.
■24510▼aModeling  and  Inference  for  Real-World  Health  Data:  Addressing  Complex  Trajectories,  Missingness,  and  Unstructured  Text
■260    ▼a[Sl]▼bThe  University  of  North  Carolina  at  Chapel  Hill▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a153  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  87-07,  Section:  B.
■500    ▼aAdvisor:  Wu,  Di;Ibrahim,  Joseph  G.
■5021  ▼aThesis  (Ph.D.)--The  University  of  North  Carolina  at  Chapel  Hill,  2025.
■520    ▼aThe  proliferation  of  complex,  high-dimensional,  and  longitudinal  data  from  sources  like  clinical  trials  and  Electronic  Health  Records  (EHRs)  presents  significant  analytical  challenges.  Standard  analytical  methods  are  often  insufficient,  as  their  underlying  assumptions  fail  to  capture  the  nuanced  dynamics  of  non-linear  disease  progression,  complex  microbial  ecosystems,  and  unstructured  clinical  text.  This  dissertation  addresses  these  limitations  by  developing  and  validating  three  novel  computational  frameworks,  each  tailored  to  the  unique  complexities  of  oncology  clinical  trials,  longitudinal  microbiome  studies,  and  unstructured  EHR  analysis,  respectively.The  first  project  introduces  a  cure  rate  joint  model  for  analyzing  longitudinal  tumor  burden  and  time-to-event  data  in  oncology.  Addressing  limitations  in  capturing  non-linear  treatment  responses,  this  model  integrates  a  random  change-point  structure  to  capture  tumor  shrinkage  and  regrowth,  alongside  a  cure-rate  component  for  long-term  control.  A  primary  innovation  is  leveraging  survival  data  to  constrain  the  change  point's  timing,  ensuring  regrowth  precedes  observed  progression.  Applied  to  a  non-small  cell  lung  cancer  trial,  this  framework  yields  accurate  treatment  effect  estimations  and  deeper  insight  into  disease  dynamics.The  second  project  addresses  irregularly-sampled  data  in  longitudinal  microbiome  studies  by  proposing  the  Bidirectional  GRU-ODE-Bayes  (BGOB)  model.  This  deep-learning  framework  uses  Neural  Ordinary  Differential  Equations  (ODE)  to  learn  continuous-time  trajectories  from  sparse  observations.  By  processing  time-series  bidirectionally,  BGOB  accurately  interpolates  missing  time  points  and  unobserved  biological  zeros  to  create  complete  data  matrices.  Applications  to  early  childhood  caries  and  inflammatory  bowel  disease  cohorts  demonstrate  that  BGOB  significantly  improves  the  statistical  power  of  downstream  analyses,  such  as  differential  abundance  testing  and  clustering.The  third  project  introduces  precLLM,  a  framework  enabling  smaller,  locally-deployed  Large  Language  Models  (LLMs)  for  unstructured  EHR  analysis  to  address  privacy  and  cost  barriers.  The  core  innovation  is  a  smart  preprocessing  step  that  filters  long  clinical  notes  to  isolate  relevant  text  before  inference.  Evaluations  on  private  and  public  EHR  datasets  show  that  this  preprocessing  enhances  the  accuracy  of  smaller  models  for  clinical  phenotyping,  often  outperforming  much  larger  models  and  proving  more  efficient  than  fine-tuning  with  limited  data.  We  also  discuss  its  potential  for  enabling  more  complex  longitudinal  analyses  of  patient  trajectories  within  EHR  data.
■590    ▼aSchool  code:  0153.
■650  4▼aBiostatistics
■650  4▼aMedicine
■650  4▼aBioinformatics
■650  4▼aClinical  psychology
■653    ▼aElectronic  Health  Records
■653    ▼aEHR  analysis
■653    ▼aClinical  trials
■653    ▼aLongitudinal  microbiome  studies
■690    ▼a0308
■690    ▼a0564
■690    ▼a0622
■690    ▼a0715
■71020▼aThe  University  of  North  Carolina  at  Chapel  Hill▼bBiostatistics.
■7730  ▼tDissertations  Abstracts  International▼g87-07B.
■790    ▼a0153
■791    ▼aPh.D.
■792    ▼a2025
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17360118▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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