mirror of
https://github.com/msberends/AMR.git
synced 2025-07-11 12:22:01 +02:00
(v2.1.1.9134) add Gamma to WISCA documentation
This commit is contained in:
@ -223,9 +223,9 @@ Note that for types 2 and 3 (Combination Antibiogram and Syndromic Antibiogram),
|
||||
|
||||
\subsection{Plotting}{
|
||||
|
||||
All types of antibiograms as listed above can be plotted (using \code{\link[ggplot2:autoplot]{ggplot2::autoplot()}} or base \R's \code{\link[=plot]{plot()}} and \code{\link[=barplot]{barplot()}}).
|
||||
All types of antibiograms as listed above can be plotted (using \code{\link[ggplot2:autoplot]{ggplot2::autoplot()}} or base \R's \code{\link[=plot]{plot()}} and \code{\link[=barplot]{barplot()}}). As mentioned above, the numeric values of an antibiogram are stored in a long format as the \link[=attributes]{attribute} \code{long_numeric}. You can retrieve them using \code{attributes(x)$long_numeric}, where \code{x} is the outcome of \code{\link[=antibiogram]{antibiogram()}} or \code{\link[=wisca]{wisca()}}.
|
||||
|
||||
THe outcome of \code{\link[=antibiogram]{antibiogram()}} can also be used directly in R Markdown / Quarto (i.e., \code{knitr}) for reports. In this case, \code{\link[knitr:kable]{knitr::kable()}} will be applied automatically and microorganism names will even be printed in italics at default (see argument \code{italicise}).
|
||||
The outcome of \code{\link[=antibiogram]{antibiogram()}} can also be used directly in R Markdown / Quarto (i.e., \code{knitr}) for reports. In this case, \code{\link[knitr:kable]{knitr::kable()}} will be applied automatically and microorganism names will even be printed in italics at default (see argument \code{italicise}).
|
||||
|
||||
You can also use functions from specific 'table reporting' packages to transform the output of \code{\link[=antibiogram]{antibiogram()}} to your needs, e.g. with \code{flextable::as_flextable()} or \code{gt::gt()}.
|
||||
}
|
||||
@ -233,7 +233,7 @@ You can also use functions from specific 'table reporting' packages to transform
|
||||
\section{Why Use WISCA?}{
|
||||
|
||||
|
||||
WISCA, as outlined by Barbieri \emph{et al.} (\doi{10.1186/s13756-021-00939-2}), stands for Weighted-Incidence Syndromic Combination Antibiogram, which estimates the probability of adequate empirical antimicrobial regimen coverage for specific infection syndromes. This method leverages a Bayesian hierarchical logistic regression framework with random effects for pathogens and regimens, enabling robust estimates in the presence of sparse data.
|
||||
WISCA, as outlined by Bielicki \emph{et al.} (\doi{10.1093/jac/dkv397}), stands for Weighted-Incidence Syndromic Combination Antibiogram, which estimates the probability of adequate empirical antimicrobial regimen coverage for specific infection syndromes. This method leverages a Bayesian hierarchical logistic regression framework with random effects for pathogens and regimens, enabling robust estimates in the presence of sparse data.
|
||||
|
||||
The Bayesian model assumes conjugate priors for parameter estimation. For example, the coverage probability \eqn{\theta} for a given antimicrobial regimen is modelled using a Beta distribution as a prior:
|
||||
|
||||
@ -247,16 +247,26 @@ Posterior parameter estimates are obtained by combining the prior and likelihood
|
||||
|
||||
\deqn{\theta | y \sim \text{Beta}(\alpha_0 + y, \beta_0 + n - y)}
|
||||
|
||||
Pathogen incidence, representing the proportion of infections caused by different pathogens, is modelled using a Dirichlet distribution, which is the natural conjugate prior for multinomial outcomes. The Dirichlet distribution is parameterised by a vector of concentration parameters \eqn{\alpha}, where each \eqn{\alpha_i} corresponds to a specific pathogen. The prior is typically chosen to be uniform (\eqn{\alpha_i = 1}), reflecting an assumption of equal prior probability across pathogens.
|
||||
|
||||
The posterior distribution of pathogen incidence is then given by:
|
||||
|
||||
\deqn{\text{Dirichlet}(\alpha_1 + n_1, \alpha_2 + n_2, \dots, \alpha_K + n_K)}
|
||||
|
||||
where \eqn{n_i} is the number of infections caused by pathogen \eqn{i} observed in the data. For practical implementation, pathogen incidences are sampled from their posterior using normalised Gamma-distributed random variables:
|
||||
|
||||
\deqn{x_i \sim \text{Gamma}(\alpha_i + n_i, 1)}
|
||||
\deqn{p_i = \frac{x_i}{\sum_{j=1}^K x_j}}
|
||||
|
||||
where \eqn{x_i} represents unnormalised pathogen counts, and \eqn{p_i} is the normalised proportion for pathogen \eqn{i}.
|
||||
|
||||
For hierarchical modelling, pathogen-level effects (e.g., differences in resistance patterns) and regimen-level effects are modelled using Gaussian priors on log-odds. This hierarchical structure ensures partial pooling of estimates across groups, improving stability in strata with small sample sizes. The model is implemented using Hamiltonian Monte Carlo (HMC) sampling.
|
||||
|
||||
Stratified results can be provided based on covariates such as age, sex, and clinical complexity (e.g., prior antimicrobial treatments or renal/urological comorbidities) using \code{dplyr}'s \code{\link[=group_by]{group_by()}} as a pre-processing step before running \code{\link[=wisca]{wisca()}}. In this case, posterior odds ratios (ORs) are derived to quantify the effect of these covariates on coverage probabilities:
|
||||
|
||||
\deqn{\text{OR}_{\text{covariate}} = \frac{\exp(\beta_{\text{covariate}})}{\exp(\beta_0)}}
|
||||
|
||||
By combining empirical data with prior knowledge, WISCA overcomes the limitations
|
||||
of traditional combination antibiograms, offering disease-specific, patient-stratified
|
||||
estimates with robust uncertainty quantification. This tool is invaluable for antimicrobial
|
||||
stewardship programs and empirical treatment guideline refinement.
|
||||
By combining empirical data with prior knowledge, WISCA overcomes the limitations of traditional combination antibiograms, offering disease-specific, patient-stratified estimates with robust uncertainty quantification. This tool is invaluable for antimicrobial stewardship programs and empirical treatment guideline refinement.
|
||||
}
|
||||
|
||||
\examples{
|
||||
|
Reference in New Issue
Block a user