TY - JOUR
T1 - Bayesian regularization to predict neuropsychiatric adverse events in smoking cessation with pharmacotherapy
AU - Truong, Van Thi Thanh
AU - Green, Charles
AU - Pedroza, Claudia
AU - Hwang, Lu Yu
AU - Rajan, Suja S.
AU - Suchting, Robert
AU - Cinciripini, Paul
AU - Tyndale, Rachel F.
AU - Lerman, Caryn
N1 - Funding Information:
This research was undertaken, in part, thanks to funding from the Canada Research Chairs program (Dr. Tyndale, the Canada Research Chair in Pharmacogenomics). Affiliation: Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health; and Departments of Pharmacology and Toxicology, and Psychiatry, University of Toronto.
Funding Information:
This research was undertaken, in part, thanks to funding from the Canada Research Chairs program (Dr. Tyndale, the Canada Research Chair in Pharmacogenomics). Affiliation: Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health; and Departments of Pharmacology and Toxicology, and Psychiatry, University of Toronto.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - Background: Research on risk factors for neuropsychiatric adverse events (NAEs) in smoking cessation with pharmacotherapy is scarce. We aimed to identify predictors and develop a prediction model for risk of NAEs in smoking cessation with medications using Bayesian regularization. Methods: Bayesian regularization was implemented by applying two shrinkage priors, Horseshoe and Laplace, to generalized linear mixed models on data from 1203 patients treated with nicotine patch, varenicline or placebo. Two predictor models were considered to separate summary scores and item scores in the psychosocial instruments. The summary score model had 19 predictors or 26 dummy variables and the item score model 51 predictors or 58 dummy variables. A total of 18 models were investigated. Results: An item score model with Horseshoe prior and 7 degrees of freedom was selected as the final model upon model comparison and assessment. At baseline, smokers reporting more abnormal dreams or nightmares had 16% greater odds of experiencing NAEs during treatment (regularized odds ratio (rOR) = 1.16, 95% credible interval (CrI) = 0.95 – 1.56, posterior probability P(rOR > 1) = 0.90) while those with more severe sleep problems had 9% greater odds (rOR = 1.09, 95% CrI = 0.95 – 1.37, P(rOR > 1) = 0.85). The prouder a person felt one week before baseline resulted in 13% smaller odds of having NAEs (rOR = 0.87, 95% CrI = 0.71 – 1.02, P(rOR < 1) = 0.94). Odds of NAEs were comparable across treatment groups. The final model did not perform well in the test set. Conclusions: Worse sleep-related symptoms reported at baseline resulted in 85%—90% probability of being more likely to experience NAEs during smoking cessation with pharmacotherapy. Treatment for sleep disturbance should be incorporated in smoking cessation program for smokers with sleep disturbance at baseline. Bayesian regularization with Horseshoe prior permits including more predictors in a regression model when there is a low number of events per variable.
AB - Background: Research on risk factors for neuropsychiatric adverse events (NAEs) in smoking cessation with pharmacotherapy is scarce. We aimed to identify predictors and develop a prediction model for risk of NAEs in smoking cessation with medications using Bayesian regularization. Methods: Bayesian regularization was implemented by applying two shrinkage priors, Horseshoe and Laplace, to generalized linear mixed models on data from 1203 patients treated with nicotine patch, varenicline or placebo. Two predictor models were considered to separate summary scores and item scores in the psychosocial instruments. The summary score model had 19 predictors or 26 dummy variables and the item score model 51 predictors or 58 dummy variables. A total of 18 models were investigated. Results: An item score model with Horseshoe prior and 7 degrees of freedom was selected as the final model upon model comparison and assessment. At baseline, smokers reporting more abnormal dreams or nightmares had 16% greater odds of experiencing NAEs during treatment (regularized odds ratio (rOR) = 1.16, 95% credible interval (CrI) = 0.95 – 1.56, posterior probability P(rOR > 1) = 0.90) while those with more severe sleep problems had 9% greater odds (rOR = 1.09, 95% CrI = 0.95 – 1.37, P(rOR > 1) = 0.85). The prouder a person felt one week before baseline resulted in 13% smaller odds of having NAEs (rOR = 0.87, 95% CrI = 0.71 – 1.02, P(rOR < 1) = 0.94). Odds of NAEs were comparable across treatment groups. The final model did not perform well in the test set. Conclusions: Worse sleep-related symptoms reported at baseline resulted in 85%—90% probability of being more likely to experience NAEs during smoking cessation with pharmacotherapy. Treatment for sleep disturbance should be incorporated in smoking cessation program for smokers with sleep disturbance at baseline. Bayesian regularization with Horseshoe prior permits including more predictors in a regression model when there is a low number of events per variable.
KW - Bayesian regularization
KW - Model selection
KW - Neuropsychiatric adverse events
KW - Prediction model
KW - Sleep disturbance
KW - Smoking cessation pharmacotherapy
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U2 - 10.1186/s12874-023-01931-7
DO - 10.1186/s12874-023-01931-7
M3 - Article
C2 - 37118656
AN - SCOPUS:85156246852
SN - 1471-2288
VL - 23
JO - BMC Medical Research Methodology
JF - BMC Medical Research Methodology
IS - 1
M1 - 107
ER -