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Data Cleaning, Preliminary Summary and Evaluation of Diagnostic Criteria of T-Cell Data in a Juvenile Onset Diabetes Cohort

Huang, Yihe (2012) Data Cleaning, Preliminary Summary and Evaluation of Diagnostic Criteria of T-Cell Data in a Juvenile Onset Diabetes Cohort. Master's Thesis, University of Pittsburgh. (Unpublished)

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Abstract

Type 1 diabetes mellitus (T1DM) is an autoimmune disease manifested by an autoimmune attack on pancreatic beta-islet cells. T1DM can occur at any age. However, it is most often diagnosed in children, adolescents, or young adults. My thesis is derived from a large longitudinal study of Juvenile Onset Diabetes (JOD) at Children’s Hospital of Pittsburgh. The objectives are: 1) Data cleaning and preliminary summary of the cohort with respect to T-cell data. 2) Evaluating the T-cell data criteria used for the prediction of the diabetes.
An extensive data examination was made for accuracy and consistency. A preliminary summary of the stimulation index (SI) for the test analytes and the number of positive antigens was performed by demographic sub-groups, HLA-DQ serotype, and follow up time. Using the ROC analysis, an evaluation of diagnosis test performance based on two different criteria was performed.
The JOD dataset had few errors with an error rate under 0.5%. The accuracy and consistency of the data is good. New onsets and first degree relatives (FDRs) nonconverters had a relatively stable SI as well as positive antigen tests results. The SI level and positive test results are higher in new onsets when compared with FDRs. FDR-converters (those subsequently developing diabetes) prior to using insulin have SIs and number of positive antigens similar to FDR-nonconverters; and FDR-converters after starting insulin have results similar to new onsets. The recommended SI cutoff of 1.5 indicating positive response appears reasonable. However, the cutoff still may be optimized for better prediction. Evidence suggests that a lower cutoff within 1.25 to 1.5 may be better and the number of positive antigens could move from ≥4 to greater than 5 or 6.
Public health significance: Development of a better understanding of the pattern of T-cell response in diabetes and non-diabetic children, and those progressing to diabetes, may give us tools to predict the early onset of disease. It is this point in time where therapeutic intervention could be focused to help stem the development of T1DM or to dramatically reduce its severity.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Huang, Yiheyihe86huang@gmail.com
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Thesis AdvisorArena, Vincent C.arena@pitt.eduARENA
Committee MemberLibman, Ingrid Mingrid.libman@chp.eduIML1
Committee MemberPike, Francispikef@upmc.edu
Date: 20 September 2012
Date Type: Completion
Defense Date: 9 August 2012
Approval Date: 20 September 2012
Submission Date: 22 August 2012
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 117
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Biostatistics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: T1DM, autoantibody, data cleaning, preliminary summary, stimulation index, positive antigen, ROC, optimal cutoff
Date Deposited: 20 Sep 2012 20:48
Last Modified: 19 Dec 2016 14:38
URI: http://d-scholarship.pitt.edu/id/eprint/13636

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