Francesca Ieva

Politecnico di Milano | Polimi · Department of Mathematics "Francesco Brioschi"

Background and objectives: Quadrivalent live attenuated influenza vaccines (LAIV-4) offer an alternative to inactivated influenza vaccines (IIV) for children aged 2-17 years, but data on their comparative effectiveness are limited. This study assessed vaccination rates and real-world effectiveness of LAIV-4 and IIV in preventing influenza and influ...

Background This study aims to analyse the effects of reducing Received Dose Intensity (RDI) in chemotherapy treatment for osteosarcoma patients on their survival by using a novel approach. Previous research has highlighted discrepancies between planned and actual RDI, even among patients randomized to the same treatment regimen. To mitigate toxic s...

Purpose Radiomics has revolutionized clinical research by enabling objective measurements of imaging-derived biomarkers. However, the true potential of radiomics necessitates a comprehensive understanding of the biological basis of extracted features to serve as a clinical decision support. In this work, we propose an end-to-end framework for the i...

Due to the presence of multiple types of adverse events (AEs) with different levels of severity, the analysis of longitudinal toxicity data is a difficult task in cancer research. The current literature primarily relies on descriptive-based methods and lacks models that can effectively quantify the overall toxic burden experienced by patients over...

Objective: Recognizing diseases from discharge letters is crucial for cohort selection and epidemiological analyses, as this is the only type of data consistently produced across hospitals. This is a classic document classification problem, typically requiring supervised learning. However, manual annotation of large datasets of discharge letters is...

Background Single-pill combination (SPC) of three antihypertensive drugs has been shown to improve adherence to therapy compared with free combinations, but little is known about its long-term costs and health consequences. This study aimed to evaluate the lifetime cost-effectiveness profile of a three-drug SPC of an angiotensin-converting enzyme i...

For many tumors, radiomics provided a relevant prognostic contribution. This study tested whether the computed tomography (CT)-based textural features of intrahepatic cholangiocarcinoma (ICC) and peritumoral tissue improve the prediction of survival after resection compared with the standard clinical indices. All consecutive patients affected by IC...

Evaluating hospitals' performance and its relation to patients' characteristics is of utmost importance to ensure timely, effective, and optimal treatment. Such a matter is particularly relevant in areas and situations where the healthcare system must contend with an unexpected surge in hospitalizations, such as for heart failure patients in the Lo...

PURPOSE Allogeneic hematopoietic stem-cell transplantation (HSCT) is the only potentially curative treatment for patients with myelodysplastic syndromes (MDS). Several issues must be considered when evaluating the benefits and risks of HSCT for patients with MDS, with the timing of transplantation being a crucial question. Here, we aimed to develop...

BACKGROUND: The aim of this paper was to analyze differences in clinical presentation, management, and short-term outcomes between vascular patients in two consecutive COVID-19 “waves” (i.e., first wave [W1], second wave [W2]) and the corresponding sub-population of COVID-19 positive (C19pos) patients. METHODS: Data from regional Lombardy (Italy) m...

PURPOSE Decision about the optimal timing of a treatment procedure in patients with hematologic neoplasms is critical, especially for cellular therapies (most including allogeneic hematopoietic stem-cell transplantation [HSCT]). In the absence of evidence from randomized trials, real-world observational data become beneficial to study the effect of...

Background This study aims to propose a semi-automatic method for monitoring the waiting times of follow-up examinations within the National Health System (NHS) in Italy, which is currently not possible to due the absence of the necessary structured information in the official databases. Methods A Natural Language Processing (NLP) based pipeline h...

We propose a discrete random effects multinomial regression model to deal with estimation and inference issues in the case of categorical and hierarchical data. Random effects are assumed to follow a discrete distribution with an a priori unknown number of support points. For a K -categories response, the modelling identifies a latent structure at...

Purpose. Allogeneic hematopoietic stem cell transplantation (HSCT) is the only potentially curative treatment for patients with myelodysplastic syndromes (MDS). Several issues must be considered when evaluating the benefits and risks of HSCT for patients with MDS, with the timing of transplantation during the disease course being a crucial question...

This study aims to analyse the effects of reducing Received Dose Intensity (RDI) in chemotherapy treatment for osteosarcoma patients on their survival by using a novel approach. In this scenario, toxic side effects are risk factors for mortality and predictors of future exposure levels, introducing post-assignment confounding. Chemotherapy administ...

Medical imaging represents the primary tool for investigating and monitoring several diseases, including cancer. The advances in quantitative image analysis have developed towards the extraction of biomarkers able to support clinical decisions. To produce robust results, multi-center studies are often set up. However, the imaging information must b...

In 2020, the COVID-19 pandemic has impacted the world, affecting health, economy, education, and social behavior. Much concern was raised about the role of mobility in the diffusion of the disease, with particular attention to public transport. Indeed, understanding the relationship between mobility and the pandemic is key for developing effective...

Simple Summary Intrahepatic cholangiocarcinoma is a disease with increasing incidence and poor prognosis. The clinicians have a limited capability to predict tumor behavior because the strongest predictors of survival are the pathology data that, unfortunately, can be determined only after surgery. Recently, radiomics, i.e., the mathematical analys...

Survival analysis is a fundamental tool in medicine, modeling the time until an event of interest occurs in a population. However, in real-world applications, survival data are often incomplete, censored, distributed, and confidential, especially in healthcare settings where privacy is critical. The scarcity of data can severely limit the scalabili...

Background Care pathways are increasingly being used to enhance the quality of care and optimize the use of resources for health care. Nevertheless, recommendations regarding the sequence of care are mostly based on consensus-based decisions as there is a lack of evidence on effective treatment sequences. In a real-world setting, classical statisti...

Due to the presence of multiple types of adverse events with different levels of severity, the analysis of longitudinal toxicity data is a difficult task in cancer studies. In this work, a novel approach based on latent Markov models and compositional data techniques is proposed. The latent status of interest is the Latent Overall Toxicity (LOTox)...

Objective: To assess which ultrasound (US) method of maximum anteroposterior (AP) abdominal aortic diameter measurement can be considered most reproducible. Data sources: MEDLINE, Scopus, and Web of Science were searched (PROSPERO ID: 276694). Eligible studies reported intra- and/or interobserver agreement according to Bland–Altman analysis (mean ±...

Objective: To investigate associations between patient characteristics, intraprocedural complexity factors, and radiation exposure to patients during endovascular abdominal aortic aneurysm repair (EVAR). Methods: Elective standard EVAR procedures between January 2015 and December 2020 were retrospectively analyzed. Patient characteristics and in...

Heart failure (HF) is a severe and costly clinical syndrome associated with increased healthcare costs and a high burden of mortality and morbidity. Although drug therapy is the mainstay of treatment for heart failure, non-adherence to prescribed therapies is common and is associated with worse health outcomes and increased hospitalizations. In thi...

This work explores how the narrative on immigration changes when society is threatened by “real” risks, i.e., during the COVID-19 health crisis. We compared the frequency and engagement of over 348,684 posts published on Facebook between December 2019 and November 2020 by Italian politicians and news media. We identified two waves of “tangible cris...

Image texture analysis has for decades represented a promising opportunity for cancer assessment and disease progression evaluation, evolving in a discipline, i.e., radiomics. However, the road to a complete translation into clinical practice is still hampered by intrinsic limitations. As purely supervised classification models fail in devising rob...

Advanced imaging and analysis improve prediction of pathology data and outcomes in several tumors, with entropy-based measures being among the most promising biomarkers. However, entropy is often perceived as statistical data lacking clinical significance. We aimed to generate a voxel-by-voxel visual map of local tumor entropy, thus allowing to (1)...

We introduce a novel statistical significance-based approach for clustering hierarchical data using semi-parametric linear mixed-effects models designed for responses with laws in the exponential family (e.g., Poisson and Bernoulli). Within the family of semi-parametric mixed-effects models, a latent clustering structure of the highest-level units...

The comprehension of the mechanisms behind the mobility of skilled workers is of paramount importance for policy making. The lacking nature of official measurements motivates the use of digital trace data extracted from ORCID public records. We use such data to investigate European regions, studied at NUTS2 level, over the time horizon of 2009 to 2...

Within the framework of precision medicine, the stratification of individual genetic susceptibility based on inherited DNA variation has paramount relevance. However, one of the most relevant pitfalls of traditional Polygenic Risk Scores (PRS) approaches is their inability to model complex high-order non-linear SNP-SNP interactions and their effect...

Simple Summary Advanced image analysis, specifically radiomics, has been recognized as a potential source of biomarkers for cancers. However, there are challenges to its application in the clinic, such as proper description of diseases where multiple lesions coexist. In this study, we aimed to characterize the intra-tumor heterogeneity of metastati...

Medical imaging represents the primary tool for investigating and monitoring several diseases, including cancer. The advances in quantitative image analysis have developed towards the extraction of biomarkers able to support clinical decisions. To produce robust results, multi-center studies are often set up. However, the imaging information must b...

Background During the COVID-19 pandemic, large-scale diagnostic testing and contact tracing have proven insufficient to promptly monitor the spread of infections. Aim To develop and retrospectively evaluate a system identifying aberrations in the use of selected healthcare services to timely detect COVID-19 outbreaks in small areas. Methods Data...

Data Science is increasingly applied for solving real-life problems, both in industry and in academic research, but mastering Data Science requires an interdisciplinary education that is still scarce on the market. Thus, there is a growing need for user-friendly tools that allow domain experts to directly apply data analysis methods to their datase...

Many applicative studies deal with multinomial responses and hierarchical data. Performing clustering at the highest level of grouping, in multilevel multinomial regression, is also often of interest. In this study we analyse Po-litecnico di Milano data with the aim of profiling students, modelling their probabilities of belonging to different cate...

Personalized medicine is the future of medical practice. In oncology, tumor heterogeneity assessment represents a pivotal step for effective treatment planning and prognosis prediction. Despite new procedures for DNA sequencing and analysis, non-invasive methods for tumor characterization are needed to impact on daily routine. On purpose, imaging t...

Background Recent evidence highlights the epidemiological value of blood DNA methylation (DNAm) as surrogate biomarker for exposure to risk factors for non-communicable diseases (NCD). DNAm surrogate of exposures predicts diseases and longevity better than self-reported or measured exposures in many cases. Consequently, disease prediction models ba...

Previous studies for cancer biomarker discovery based on pre-diagnostic blood DNA methylation (DNAm) profiles, either ignore the explicit modeling of the Time To Diagnosis (TTD), or provide inconsistent results. This lack of consistency is likely due to the limitations of standard EWAS approaches, that model the effect of DNAm at CpG sites on TTD i...

The concept of care pathways is increasingly being used to enhance the quality of care and to optimize the use of resources for health care. Nevertheless, recommendations regarding the sequence of care are mostly based on consensus-based decisions as there is a lack of evidence on effective treatment sequences. In a real-world setting, classical st...

Personalized medicine is the future of medical practice. In oncology, tumor heterogeneity assessment represents a pivotal step for effective treatment planning and prognosis prediction. Despite new procedures for DNA sequencing and analysis, non-invasive methods for tumor characterization are needed to impact on daily routine. On purpose, imaging t...

Purpose Intrahepatic cholangiocarcinoma (IHC) is an aggressive disease with few reliable preoperative biomarkers. This study aims to elucidate if radiomics extracted from preoperative [18F]FDG PET/CT may grant a non-invasive biological characterization of IHC and predict outcome after complete resection of the tumor. Methods All patients preoperat...

Finding effective ways to perform cancer sub-typing is currently a trending research topic for therapy opti-mization and personalized medicine. Stemming from genomic field, several algorithms have been proposed. In the context of texture analysis, limited efforts have been attempted, yet imaging information is known to entail useful knowledge for c...

Time-varying covariates are of great interest in clinical research since they represent dynamic patterns which reflect disease progression. In cancer studies biomarkers values change as functions of time and chemotherapy treatment is modified by delaying a course or reducing the dose intensity, according to patient’s toxicity levels. In this work,...

Background: Recent evidence highlights the epidemiological value of blood DNA methylation (DNAm) as surrogate biomarker for exposures to risk factors for non-communicable diseases (NCD). DNAm surrogate of exposures predict diseases and longevity better than self-reported or measured exposures in many cases. Consequently, disease prediction models b...

Within the framework of precision medicine, the stratification of individual genetic susceptibility based on inherited DNA variation has paramount relevance. However, one of the most relevant pitfalls of traditional Polygenic Risk Scores (PRS) approaches is their inability to model complex high-order non-linear SNP-SNP interactions and their effect...

Statistical methods to study the association between a longitudinal biomarker and the risk of death are a very relevant problem for the long-term monitoring of biomarkers. In this context, sudden crises can cause the biomarker to undergo very abrupt changes. Although these oscillations are typically short-term, they can contain prognostic informati...

div> Image texture analysis has for decades represented a promising opportunity for cancer assessment and disease progression evaluation, evolving over time in a discipline, i.e., radiomics. However, the road for a complete translation into clinical practice is still hampered by intrinsic limitations. As purely supervised classification models fa...

div> Image texture analysis has for decades represented a promising opportunity for cancer assessment and disease progression evaluation, evolving over time in a discipline, i.e., radiomics. However, the road for a complete translation into clinical practice is still hampered by intrinsic limitations. As purely supervised classification models fa...

Previous studies for cancer biomarker discovery based on pre-diagnostic blood DNA methylation profiles, either ignore the explicit modeling of the time to diagnosis (TTD) as in a survival analysis setting, or provide inconsistent results. This lack of consistency is likely due to the limitations of standard EWAS approaches, that model the effect of...

Background: to find clinical features that can predict prognosis in patients with oligometastatic disease treated with stereotactic body radiotherapy (SBRT). Material and methods: Patients with less than 5 metastases in less than 3 different body sites were included in the analysis. Various clinical and treatment parameters were analyzed to crea...

Background: Congestive Heart Failure (HF) is a widespread chronic disease characterized by a very high incidence in elder people. The high mortality and readmission rate of HF strongly depends on the complicated morbidity scenario often characterising it. Methods: Data were retrieved from the healthcare administrative datawarehouse of Lombardy, the...

Funding Acknowledgements Type of funding sources: None. AIM [18F]FDG-PET/CT is part of the diagnostic algorithm for IE diagnosis. Increased [18F]FDG uptake with focal and heterogenous pattern at valve, intravalvular or perivalvular at visual analysis is consistent with IE. Diffuse, homogeneous or low valvular [18F]FDG uptake make diagnosis more cha...

In recent years, there has been a widespread cross-fertilization between Medical Statistics and Machine Learning (ML) techniques.

The creation of non invasive biomarkers from blood DNA methylation profiles is a cutting-edge achievement in personalized medicine: DNAm epimutations have been demonstrated to be tightly related to lifestyle and environmental risk factors, ultimately providing an unbiased proxy of an individual state of health. At present, the creation of DNAm surr...

This paper combines a theoretical-based model with a data-driven approach to develop an Early Warning System that detects students who are more likely to dropout. The model uses innovative multilevel statistical and machine learning methods. The paper demonstrates the validity of the approach by applying it to administrative data from a leading Ita...