As an example of the utility of the PDATK package, we provide code
replicating the analysis published in Sandhu et al. (2019). While the
code presented here is run on a subset of the original data to ensure that
the PDATK installation size is not too large, the full data from that study can
is available via the MetaGxPancreas
Bioconductor data package.
data(sampleCohortList)
sampleCohortList
## CohortList of length 11
## names(11): ICGCMICRO ICGCSEQ PCSI TCGA KIRBY UNC CHEN COLLISON ZHANG OUH WINTER
To get started using PDATK, place each of your patient cohorts into
SurvivalExperiment
objects and then assemble those into a master CohortList
,
which holds the training and validation data for use with the various
SurvivalModel
s in this package.
commonGenes <- findCommonGenes(sampleCohortList)
# Subsets all list items, with subset for specifying rows and select for
# specifying columns
cohortList <- subset(sampleCohortList, subset=commonGenes)
ICGCcohortList <- cohortList[grepl('ICGC', names(cohortList), ignore.case=TRUE)]
validationCohortList <- cohortList[!grepl('icgc', names(cohortList),
ignore.case=TRUE)]
Since we are interested in predicting survival, it is necessary to remove patients with insufficient data to be useful. In general, we want to remove patients who did not have an event in our period of interest. As such we remove samples who dropped out of a study, but did not pass away before the first year.
validationCohortList <- dropNotCensored(validationCohortList)
ICGCcohortList <- dropNotCensored(ICGCcohortList)
We have now split our patient cohorts into training and validation data. For this analysis we will be training using the ICGC cohorts, which includes one cohort with RNA micro-array data and another with RNA sequencing data. When using multiple cohorts to train a model, it is required that those cohorts share samples. As a result we will take as training data all patients shared between the two cohorts and leave the remainder of patients as part of our validationData.
# find common samples between our training cohorts in a cohort list
commonSamples <- findCommonSamples(ICGCcohortList)
# split into shared samples for training, the rest for testing
ICGCtrainCohorts <- subset(ICGCcohortList, select=commonSamples)
ICGCtestCohorts <- subset(ICGCcohortList, select=commonSamples, invert=TRUE)
# merge our training cohort test data into the rest of the validation data
validationCohortList <- c(ICGCtestCohorts, validationCohortList)
# drop ICGCSEQ from the validation data, because it only has 7 patients
validationCohortList <-
validationCohortList[names(validationCohortList) != 'ICGCSEQ']
PCOSP
Model ObjectWe now have patient molecular data, annotated with the number of days survived
since treatment and the survival status and are ready to apply a SurvivalModel
to this data. In this example, we are applying a Pancreatic Cancer Overall
Survival Model, as described in switchBox
package to create an ensemble of binary classifiers, whos votes are
then tallied into a PCOSP score. A PCOSP score is simply the proportion of
models predicting good survival out of the total number of models in the
ensemble.
set.seed(1987)
PCOSPmodel <- PCOSP(ICGCtrainCohorts, minDaysSurvived=365, randomSeed=1987)
# view the model parameters; these make your model run reproducible
metadata(PCOSPmodel)$modelParams
## $randomSeed
## [1] 1987
##
## $RNGkind
## [1] "Mersenne-Twister" "Inversion" "Rejection"
##
## $minDaysSurvived
## [1] 365
To simplify working with different SurvivalModel
sub-classes, we have
implemented a standard work-flow that is valid for all SurvivalModel
s.
This involves first training the model, then using it to predict
risk/risk-classes for a set of validation cohorts and finally assessing
performance on the validation data.
To train a model, the trainModel
method is used. This function abstracts away
the implementation of model training, allowing end-users to focus on applying
the SurvivalModel
to make predictions without a need to understand the model
internals. We hope this will make the package useful for those unfamiliar or
uninterested in the details of survival prediction methods.
For training a PCOSP model there are two parameters. First, numModels
is the
number of models to train for use in the ensemble classifier to predict PCOSP
scores. To keep computation brief, we are only training 25 models. However, it
is recommended to use a minimum of 1000 for real world applications. The second
parameter is minAccuracy
, which is the minimum model accuracy for a trained
model to included in the final model ensemble. Paradoxically, increasing this
too high can actually decrease the overall performance of the PCOSP model. We
recommend 0.6 as a sweet spot between random chance and over-fitting but
encourage experimentation to see what works best with your data.
trainedPCOSPmodel <- trainModel(PCOSPmodel, numModels=15, minAccuracy=0.6)
metadata(trainedPCOSPmodel)$modelParams
## $randomSeed
## [1] 1987
##
## $RNGkind
## [1] "Mersenne-Twister" "Inversion" "Rejection"
##
## $minDaysSurvived
## [1] 365
##
## $numModels
## [1] 15
##
## $minAccuracy
## [1] 0.6
We can see that after training, the additional model parameters are added to the
modelParams
item in the model metadata
. The goal is to ensure that your
model training, prediction and validation are fully reproducible by capturing
the parameters relevant to a specific model.
After training, a model can now be used with new data to make risk predictions
and classify samples into ‘good’ or ‘bad’ survival groups. To do this, the
standard predictClasses
method is used. Similar to trainData
, we have
abstracted away the implementation details to provide users with a simple,
consistent interface for using SurvivalModel
sub-classes to make patient risk
predictions.
PCOSPpredValCohorts <- predictClasses(validationCohortList,
model=trainedPCOSPmodel)
The returned CohortList
object now indicates that each of the cohorts have
predictions. This information is available in the elementMetadata
slot of
the cohort list and can be accessed with the mcols
function from S4Vectors
.
mcols(PCOSPpredValCohorts)
## DataFrame with 10 rows and 2 columns
## mDataType hasPredictions
## <character> <logical>
## ICGCMICRO rna_micro TRUE
## PCSI rna_seq TRUE
## TCGA rna_seq TRUE
## KIRBY rna_seq TRUE
## UNC rna_micro TRUE
## CHEN rna_micro TRUE
## COLLISON rna_micro TRUE
## ZHANG rna_micro TRUE
## OUH rna_micro TRUE
## WINTER rna_micro TRUE
Predicting risk with a specific model adds a corresponding metadata
column to the object colData
. In the case of a PCOSP
model, the new column
is called PCOSP_prob_good
and represents the proportion of models in the
ensemble which predicted good survival for a given sample.
knitr::kable(head(colData(PCOSPpredValCohorts[[1]])))
unique_patient_ID | grade | sex | age | T | N | M | sample_type | sample_name | survival_time | event_occurred | prognosis | PCOSP_prob_good | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
ICGC_0001 | ICGC_0001 | G1 | M | 59 | T2 | N0 | M0 | tumour | ICGC_0001 | 522 | 1 | good | 0.6666667 |
ICGC_0002 | ICGC_0002 | G2 | F | 77 | T2 | N1a | MX | tumour | ICGC_0002 | 2848 | 1 | good | 0.4666667 |
ICGC_0003 | ICGC_0003 | G2 | F | 58 | T3 | N1a | MX | tumour | ICGC_0003 | 1778 | 0 | good | 0.9333333 |
ICGC_0004 | ICGC_0004 | G2 | F | 78 | T2 | N0 | MX | tumour | ICGC_0004 | 1874 | 1 | good | 1.0000000 |
ICGC_0005 | ICGC_0005 | G3 | M | 63 | T3 | N1b | MX | tumour | ICGC_0005 | 641 | 1 | good | 0.5333333 |
ICGC_0008 | ICGC_0008 | G2 | M | 72 | T3 | N1b | MX | tumour | ICGC_0008 | 1209 | 1 | good | 0.8000000 |
Additionally, binary predictions of good or bad survival can be found in the
PCOSPpredictions
item of each SurvivalExperiment
s metadata
. This contains
the raw predictions from the model for each classifier in the ensemble, ordered
by classifier accuracy. This data is not important for end users, but is used
internally when calculating validation statistics for the model. For users
wishing to classify samples rather than estimate risks, we recommend a
PCOSP cut-off of >0.5 for good survival prognosis.
knitr::kable(metadata(PCOSPpredValCohorts[[1]])$PCOSPpredictions[1:5, 1:5])
ICGC_0001 | ICGC_0002 | ICGC_0003 | ICGC_0004 | ICGC_0005 | |
---|---|---|---|---|---|
rank1 | bad | bad | good | good | good |
rank2 | good | good | good | good | bad |
rank3 | good | good | good | good | good |
rank4 | bad | good | good | good | good |
rank5 | good | bad | good | good | bad |
The final step in the standard SurvivalModel
work-flow is to compute
model performance statistics for the model on the validation data. This can be
accomplished using the validateModel
method, which will add statistics to the
validationStats
slot of a SurvivalModel
object and the data to the
validationData
slot.
validatedPCOSPmodel <- validateModel(trainedPCOSPmodel,
valData=PCOSPpredValCohorts)
knitr::kable(head(validationStats(validatedPCOSPmodel)))
statistic | estimate | se | lower | upper | p_value | n | cohort | isSummary | mDataType |
---|---|---|---|---|---|---|---|---|---|
AUC | 0.7070000 | 0.0470000 | 0.6150000 | 0.7990000 | 0.0000142 | 158 | ICGCMICRO | FALSE | rna_micro |
log_D_index | 0.5956475 | 0.1592665 | 0.4882238 | 0.7030711 | 0.0001668 | 158 | ICGCMICRO | FALSE | rna_micro |
concordance_index | 0.6434057 | 0.0321350 | 0.5804223 | 0.7063892 | 0.0000081 | 158 | ICGCMICRO | FALSE | rna_micro |
AUC | 0.6400000 | 0.0570000 | 0.5280000 | 0.7530000 | 0.0088634 | 107 | PCSI | FALSE | rna_seq |
log_D_index | 0.4697159 | 0.1838308 | 0.3457239 | 0.5937078 | 0.0105421 | 107 | PCSI | FALSE | rna_seq |
concordance_index | 0.6212825 | 0.0387126 | 0.5454073 | 0.6971577 | 0.0017309 | 107 | PCSI | FALSE | rna_seq |
Examining the data.table
from the validationStats
slot we can see that three
model performance statistics have been calculated for all of the validation
cohorts. Additionally, aggregate statistics have been calculated by molecular
data type and for all cohorts combined. This table can be used to generate
model performance plots. We have included several functions for examining
model performance.
PCOSPdIndexForestPlot <- forestPlot(validatedPCOSPmodel, stat='log_D_index')
PCOSPdIndexForestPlot
PCOSPconcIndexForestPlot <- forestPlot(validatedPCOSPmodel, stat='concordance_index')
PCOSPconcIndexForestPlot
cohortROCplots <- plotROC(validatedPCOSPmodel, alpha=0.05)
## Warning: The `<scale>` argument of `guides()` cannot be `FALSE`. Use "none" instead as
## of ggplot2 3.3.4.
## ℹ The deprecated feature was likely used in the PDATK package.
## Please report the issue at <https://github.com/bhklab/PDATK/issues>.
## This warning is displayed once every 8 hours.
## Call `lifecycle::last_lifecycle_warnings()` to see where this warning was
## generated.
cohortROCplots
To compare the performance of a PCOSP model to random chance, we have included two model classes which permute either patient prognosis labels or the feature names. These models can be used to evaluate if a PCOSP model performs better than random chance.
The RLSModel
class is a SurvivalModel
using the same risk prediction
algorithm as a PCOSP
model, but randomizing the patient prognosis labels
in each of the individual KTSP classifiers used in the classification ensemble.
Given this random prognosis label shuffling, we expect the classification
results for this model to be no better than random chance.
The work-flow for this model follows the standard SurvivalModel
sub-class
work-flow.
# Merge to a single SurvivalExperiment
ICGCtrainCohorts <- merge(ICGCtrainCohorts[[1]], ICGCtrainCohorts[[2]],
cohortNames=names(ICGCtrainCohorts))
RLSmodel <- RLSModel(ICGCtrainCohorts, minDaysSurvived=365, randomSeed=1987)
trainedRLSmodel <- trainModel(RLSmodel, numModels=15)
RLSpredCohortList <- predictClasses(validationCohortList, model=trainedRLSmodel)
## Warning in FUN(X[[i]], ...):
## [PDATK::NULL] Dropped samples with NA survival data!
## Warning in FUN(X[[i]], ...):
## [PDATK::NULL] Dropped samples with NA survival data!
## Warning in FUN(X[[i]], ...):
## [PDATK::NULL] Dropped samples with NA survival data!
validatedRLSmodel <- validateModel(trainedRLSmodel, RLSpredCohortList)
To compare the performance of a permuted model to that of a PCOSP model, we
have included the densityPlotModelComparion
method, which plots a
density plot of model AUCs per molecular data type and overall. The dotted
line represents the mean AUC of the PCOSP model. From this plot we can
see that the PCOSP model performs significantly better than the random label
shuffling model.
RLSmodelComparisonPlot <- densityPlotModelComparison(validatedRLSmodel,
validatedPCOSPmodel, title='Random Label Shuffling vs PCOSP',
mDataTypeLabels=c(rna_seq='Sequencing-based', rna_micro='Array-based',
combined='Overall'))
RLSmodelComparisonPlot
A RandomGeneAssignmentModel
(aliased as RGAModel
for user convenience)
is similar to a RLSModel
except that the gene labels are randomized for
each KTSP classifier in the ensemble. In this case, we also expect this
model to perform no better than random chance.
RGAmodel <- RGAModel(ICGCtrainCohorts, randomSeed=1987)
trainedRGAmodel <- trainModel(RGAmodel, numModels=15)
RGApredCohortList <- predictClasses(validationCohortList,
model=trainedRGAmodel)
## Warning in FUN(X[[i]], ...):
## [PDATK::NULL] Dropped samples with NA survival data!
## Warning in FUN(X[[i]], ...):
## [PDATK::NULL] Dropped samples with NA survival data!
## Warning in FUN(X[[i]], ...):
## [PDATK::NULL] Dropped samples with NA survival data!
validatedRGAmodel <- validateModel(trainedRGAmodel, RGApredCohortList)
The density plot for the RGAModel
also shows that the PCOSP
model does
significantly better than random chance.
RGAmodelComparisonPlot <- densityPlotModelComparison(validatedRGAmodel,
validatedPCOSPmodel, title='Random Gene Assignment vs PCOSP',
mDataTypeLabels=c(rna_seq='Sequencing-based', rna_micro='Array-based',
combined='Overall'))
RGAmodelComparisonPlot
Confident that the PCOSP model is performing better than random chance at
prediction patient survival, we can now begin to look into the features that
are most relevant to these predictions. Once we have extracted the features,
we will use the runGSEA
method to evaluate which pathways these genes are
representative of.
We can get the features which are most predictive from a SurvivalModel
object using the getTopFeatures
method. By default this retrieves the
gene names from the top 10% of models in the SurvivalModel
. Users can
customize the top N models to extract genes from using the numModels
parameter.
topFeatures <- getTopFeatures(validatedPCOSPmodel)
topFeatures
## [1] "ATOX1" "NAMPT" "KRT6A" "FCGRT" "SERTAD4" "ZNF792"
## [7] "KRT6C" "BIRC3" "PKIB" "SSBP3" "PPFIBP2" "FBLIM1"
## [13] "ZSCAN29" "KRT15" "UBE2C" "C16orf74" "BLNK" "MARK3"
To perform pathway analysis, which is done internally using the
piano::runGSAhyper
function we first to pathway data to query against.
We recommend using the msigdbr
R package to fetch pathways of interest.
Because of the small number of genes included in the sample patient cohorts, this section will not find any enriched pathways and therefore this code is not run.
allHumanGeneSets <- msigdbr()
allGeneSets <- as.data.table(allHumanGeneSets)
geneSets <- allGeneSets[grepl('^GO.*|.*CANONICAL.*|^HALLMARK.*', gs_name),
.(gene_symbol, gs_name)]
GSEAresultDT <- runGSEA(validatedPCOSPmodel, geneSets)
Equipped with a risk prediction model performing better than random chance,
the next pertinent question is: does it out perform simpler models? To answer
this question we have included the ClinicalModel
class, which leverages the
glm
function from the stats
package to fit a generalized linear model based
on a set of clinical variables in the patient metadata. To do this, we need to
specify a model formula based on the column names available in the colData
slot of our training data SurvivalExpeiment
objects. All formula parameters
must be valid column names in the colData
of the training cohorts. The same
patient metadata must be present in any validation cohorts used to make risk
predictions.
We can see there are a number of clinical variables related to patient survived in the patient metadata. For our model, we will be using patient sex, age and tumour grade along with the TNM staging of the tumour.
knitr::kable(head(colData(ICGCtrainCohorts)))
unique_patient_ID | grade | sex | age | T | N | M | sample_type | sample_name | survival_time | event_occurred | prognosis | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
ICGC_0006 | ICGC_0006 | G2 | F | 49 | T1 | N1b | MX | tumour | ICGC_0006 | 1715 | 0 | good |
ICGC_0007 | ICGC_0007 | G2 | F | 74 | T3 | N1b | MX | tumour | ICGC_0007 | 56 | 1 | bad |
ICGC_0009 | ICGC_0009 | G4 | M | 34 | T3 | N0 | MX | tumour | ICGC_0009 | 399 | 1 | good |
ICGC_0020 | ICGC_0020 | G2 | M | 57 | T3 | N1b | MX | tumour | ICGC_0020 | 1259 | 1 | good |
ICGC_0021 | ICGC_0021 | G3 | M | 60 | T3 | N1b | MX | tumour | ICGC_0021 | 715 | 1 | good |
ICGC_0025 | ICGC_0025 | G3 | M | 69 | T3 | N1b | MX | tumour | ICGC_0025 | 348 | 1 | bad |
clinicalModel <- ClinicalModel(ICGCtrainCohorts,
formula='prognosis ~ sex + age + T + N + M + grade',
randomSeed=1987)
trainedClinicalModel <- trainModel(clinicalModel)
Clinical annotations are only available for a subset of our patient cohorts,
thus we subset our cohort list to ensure the model works as expected. Variable
columns with levels of a model parameter which are not present in the original
model will be dropped automatically. To prevent this behavior, it is necessary
to add any missing levels to the colData
of the training data before training
the model. The easiest way to achieve this is by converting the columns in
question into factors and ensuring all levels in the training and validation
data are set for those columns.
hasModelParamsCohortList <-
PCOSPpredValCohorts[c('ICGCMICRO', 'TCGA', 'PCSI', 'OUH')]
clinicalPredCohortList <- predictClasses(hasModelParamsCohortList,
model=trainedClinicalModel)
## Warning in .local(object, model, ...):
## [PDATK::NULL] Rows 120, 155 have levels that are not in the model, skipping these rows...
validatedClinicalModel <- validateModel(trainedClinicalModel,
clinicalPredCohortList)
To get a general idea of how the ClinicalModel
performed relative to the
PCOSP
model, the barPlotModelComaprison
can be used to show the . For
this example, we will compare the AUC of the models in each of the validation
cohorts. Other statistics in the validationStats
slot can be used by changing
the stat
argument to the plotting function.
clinicalVsPCOSPbarPlot <- barPlotModelComparison(validatedClinicalModel,
validatedPCOSPmodel, stat='AUC')
clinicalVsPCOSPbarPlot
To reduce the number of plotting functions and simplify meta-analysis of many
models of different types, we have included the ModelComparison
object. This
object aggregates the validation statistics from two models. Plotting methods
can then be dispatched on this class, greatly simplifying the process of
comparing several SurivalModel
sub-classes. You can also compare a model to
an existing model comparison, and in this way built up a collection of model
performance statistics which can be visualized in a forest plot to enable
complex comparisons between many models.
Below, we use this feature to compare the PCOSP and ClinicalModels
based on
D index and concordance index, as calculated using the survcomp
R package.
clinicalVsPCOSP <- compareModels(validatedClinicalModel, validatedPCOSPmodel)
clinVsPCOSPdIndexForestPlot <- forestPlot(clinicalVsPCOSP, stat='log_D_index')
clinVsPCOSPdIndexForestPlot
clinVsPCOSPconcIndexForestPlot <- forestPlot(clinicalVsPCOSP,
stat='concordance_index')
clinVsPCOSPconcIndexForestPlot
To get and idea of how our PCOSP model stacks up against other classifiers
from the literature, we have included the GeneFuModel
class. This
SurvivalModel
performs risk prediction using a set of genes and corresponding
coefficients using the genefu::sig.score
function. We have included data
for three published classifiers from Chen et al. (2015), Birnbaum et al.
(2017) and Haider et al. (2014).
Since there is no training data for the published classifiers, we create
empty GeneFuModel
objects, then assign the model predictors to the models
slot of each respective object.
chenGeneFuModel <- GeneFuModel(randomSeed=1987)
birnbaumGeneFuModel <- GeneFuModel(randomSeed=1987)
haiderGeneFuModel <- GeneFuModel(randomSeed=1987)
For the Haider model, we were unable to get the genes and coefficients. However, the author provided the risk scores. As a result we need to do a bit of work to get the Haider GeneFuModel to work with the package function.
data(existingClassifierData)
models(chenGeneFuModel) <- SimpleList(list(chen=chen))
models(birnbaumGeneFuModel) <- SimpleList(list(birnbuam=birnbaum))
models(haiderGeneFuModel) <- SimpleList(list(haider=NA))
chenClassPredictions <- predictClasses(PCOSPpredValCohorts[names(haiderSigScores)],
model=chenGeneFuModel)
birnClassPredictions <- predictClasses(PCOSPpredValCohorts[names(haiderSigScores)],
model=birnbaumGeneFuModel)
haiderClassPredictions <- PCOSPpredValCohorts[names(haiderSigScores)]
# Manually assign the scores to the prediction cohorts
for (i in seq_along(haiderClassPredictions)) {
colMData <- colData(haiderClassPredictions[[i]])
colMData$genefu_score <- NA_real_
colMData[rownames(colMData) %in% names(haiderSigScores[[i]]), ]$genefu_score <-
haiderSigScores[[i]][names(haiderSigScores[[i]]) %in% rownames(colMData)]
colData(haiderClassPredictions[[i]]) <- colMData
}
# Setup the correct model metadata
mcols(haiderClassPredictions)$hasPredictions <- TRUE
metadata(haiderClassPredictions)$predictionModel <- haiderGeneFuModel
validatedChenModel <- validateModel(chenGeneFuModel, valData=chenClassPredictions)
validatedBirnbaumModel <- validateModel(birnbaumGeneFuModel,
valData=birnClassPredictions)
validatedHaiderModel <- validateModel(haiderGeneFuModel, valData=haiderClassPredictions)
genefuModelComparisons <- compareModels(validatedChenModel,
validatedBirnbaumModel, modelNames=c('Chen', 'Birnbaum'))
genefuModelComparisons <- compareModels(genefuModelComparisons,
validatedHaiderModel, model2Name='Haider')
allModelComparisons <- compareModels(genefuModelComparisons, validatedPCOSPmodel,
model2Name='PCOSP')
# We are only interested in comparing the summaries, so we subset our model comparison
allModelComparisons <- subset(allModelComparisons, isSummary == TRUE)
allDindexComparisonForestPlot <- forestPlot(allModelComparisons,
stat='log_D_index', colourBy='model', groupBy='mDataType')
allDindexComparisonForestPlot
allConcIndexComparisonForestPlot <- forestPlot(allModelComparisons,
stat='concordance_index', colourBy='model', groupBy='mDataType')
allConcIndexComparisonForestPlot
From the two forest plots, we can see that the PCOSP
model matched our
outperformed all of the public classifiers, even when only trained with 100
models. It is likely that using 1000 models, we would see even better separation
of the PCOSP
model. Indeed, this is was the result in Sandhu et al. (2019).
data(cohortSubtypeDFs)
# Add the subtypes to the prediction cohort
subtypedPCOSPValCohorts <- assignSubtypes(PCOSPpredValCohorts, cohortSubtypeDFs)
subtypeValidatedPCOSPmodel <- validateModel(trainedPCOSPmodel, valData=subtypedPCOSPValCohorts)
## <simpleError in doTryCatch(return(expr), name, parentenv, handler): report ROC failed>
## <simpleError in wilcox.test.default(pred[obs == 1], pred[obs == 0], alternative = "great"): not enough (non-missing) 'x' observations>
## <simpleError in if (AUC.low > 0.5 & P >= 0.05) { wilc.t = wilcox.test(predictor[table.gold == 1], predictor[table.gold == 0], alternative = "less", exact = exact) P = wilc.t$p.value}: missing value where TRUE/FALSE needed>
forestPlot(subtypeValidatedPCOSPmodel, stat='log_D_index', groupBy='cohort',
colourBy='subtype')
## Warning: Removed 1 row containing missing values or values outside the scale range
## (`geom_pointrange()`).
forestPlot(subtypeValidatedPCOSPmodel, stat='concordance_index', groupBy='cohort',
colourBy='subtype')
## Warning: Removed 1 row containing missing values or values outside the scale range
## (`geom_pointrange()`).
## Warning: Removed 1 row containing missing values or values outside the scale range
## (`geom_segment()`).
Sandhu V, Labori KJ, Borgida A, et al. Meta-Analysis of 1,200 Transcriptomic Profiles Identifies a Prognostic Model for Pancreatic Ductal Adenocarcinoma. JCO Clin Cancer Inform. 2019;3:1-16. doi:10.1200/CCI.18.00102
Chen DT, Davis-Yadley AH, Huang PY, et al. Prognostic Fifteen-Gene Signature for Early Stage Pancreatic Ductal Adenocarcinoma. PLoS One. 2015;10(8):e0133562. Published 2015 Aug 6. doi:10.1371/journal.pone.0133562
Birnbaum DJ, Finetti P, Lopresti A, et al. A 25-gene classifier predicts overall survival in resectable pancreatic cancer. BMC Med. 2017;15(1):170. Published 2017 Sep 20. doi:10.1186/s12916-017-0936-z
Haider S, Wang J, Nagano A, et al. A multi-gene signature predicts outcome in patients with pancreatic ductal adenocarcinoma. Genome Med. 2014;6(12):105. Published 2014 Dec 3. doi:10.1186/s13073-014-0105-3