Handling confounding variables in statistical shape analysis - application to cardiac remodelling

Statistical shape analysis is a powerful tool to assess organ morphologies and find shape changes associated to a particular disease. However, imbalance in confounding factors, such as demographics might invalidate the analysis if not taken into consideration. Despite the methodological advances in...

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Bibliographic Details
Authors: Bernardino Perez, Gabriel, Benkarim, Oualid M., Sanz de la Garza, Maria, Prat Gonzàlez, Susanna, Sepúlveda-Martínez, Álvaro, Crispi Brillas, Fàtima, Sitges, Marta, Butakoff, Constantine, Craene, Mathieu de, Bijnens, Bart, González Ballester, Miguel Ángel, 1973-
Format: article
Status:Versión aceptada para publicación
Publication Date:2020
Country:España
Institution:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repository:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/45146
Online Access:http://hdl.handle.net/10230/45146
http://dx.doi.org/10.1016/j.media.2020.101792
Access Level:Open access
Keyword:Confounder correction
Statistical shape analysis
Computational anatomy
Cardiac remodelling
Description
Summary:Statistical shape analysis is a powerful tool to assess organ morphologies and find shape changes associated to a particular disease. However, imbalance in confounding factors, such as demographics might invalidate the analysis if not taken into consideration. Despite the methodological advances in the field, providing new methods that are able to capture complex and regional shape differences, the relationship between non-imaging information and shape variability has been overlooked. We present a linear statistical shape analysis framework that finds shape differences unassociated to a controlled set of confounding variables. It includes two confounding correction methods: confounding deflation and adjustment. We applied our framework to a cardiac magnetic resonance imaging dataset, consisting of the cardiac ventricles of 89 triathletes and 77 controls, to identify cardiac remodelling due to the practice of endurance exercise. To test robustness to confounders, subsets of this dataset were generated by randomly removing controls with low body mass index, thus introducing imbalance. The analysis of the whole dataset indicates an increase of ventricular volumes and myocardial mass in athletes, which is consistent with the clinical literature. However, when confounders are not taken into consideration no increase of myocardial mass is found. Using the downsampled datasets, we find that confounder adjustment methods are needed to find the real remodelling patterns in imbalanced datasets.