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      Web-Based Survival Analysis Tool Tailored for Medical Research (KMplot): Development and Implementation

      research-article
      , MSc 1 , 2 , , MD, PhD, DSC 1 , 2 ,
      (Reviewer), (Reviewer)
      Journal of Medical Internet Research
      JMIR Publications
      Kaplan-Meier plot, internet, Cox regression, follow-up, multivariate analysis, survival

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          Abstract

          Background

          Survival analysis is a cornerstone of medical research, enabling the assessment of clinical outcomes for disease progression and treatment efficiency. Despite its central importance, no commonly used spreadsheet software can handle survival analysis and there is no web server available for its computation.

          Objective

          Here, we introduce a web-based tool capable of performing univariate and multivariate Cox proportional hazards survival analysis using data generated by genomic, transcriptomic, proteomic, or metabolomic studies.

          Methods

          We implemented different methods to establish cut-off values for the trichotomization or dichotomization of continuous data. The false discovery rate is computed to correct for multiple hypothesis testing. A multivariate analysis option enables comparing omics data with clinical variables.

          Results

          We established a registration-free web-based survival analysis tool capable of performing univariate and multivariate survival analysis using any custom-generated data.

          Conclusions

          This tool fills a gap and will be an invaluable contribution to basic medical and clinical research.

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          Most cited references24

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          Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing

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            Comprehensive molecular portraits of human breast tumors

            Summary We analyzed primary breast cancers by genomic DNA copy number arrays, DNA methylation, exome sequencing, mRNA arrays, microRNA sequencing and reverse phase protein arrays. Our ability to integrate information across platforms provided key insights into previously-defined gene expression subtypes and demonstrated the existence of four main breast cancer classes when combining data from five platforms, each of which shows significant molecular heterogeneity. Somatic mutations in only three genes (TP53, PIK3CA and GATA3) occurred at > 10% incidence across all breast cancers; however, there were numerous subtype-associated and novel gene mutations including the enrichment of specific mutations in GATA3, PIK3CA and MAP3K1 with the Luminal A subtype. We identified two novel protein expression-defined subgroups, possibly contributed by stromal/microenvironmental elements, and integrated analyses identified specific signaling pathways dominant in each molecular subtype including a HER2/p-HER2/HER1/p-HER1 signature within the HER2-Enriched expression subtype. Comparison of Basal-like breast tumors with high-grade Serous Ovarian tumors showed many molecular commonalities, suggesting a related etiology and similar therapeutic opportunities. The biologic finding of the four main breast cancer subtypes caused by different subsets of genetic and epigenetic abnormalities raises the hypothesis that much of the clinically observable plasticity and heterogeneity occurs within, and not across, these major biologic subtypes of breast cancer.
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              Regression Models and Life-Tables

              D R Cox (1972)
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                July 2021
                26 July 2021
                : 23
                : 7
                : e27633
                Affiliations
                [1 ] Department of Bioinformatics Semmelweis University Budapest Hungary
                [2 ] TTK Lendület Cancer Biomarker Research Group Institute of Enzymology Research Centre for Natural Sciences Budapest Hungary
                Author notes
                Corresponding Author: Balázs Győrffy gyorffy.balazs@ 123456med.semmelweis-univ.hu
                Author information
                https://orcid.org/0000-0002-2600-7038
                https://orcid.org/0000-0002-5772-3766
                Article
                v23i7e27633
                10.2196/27633
                8367126
                34309564
                51cc97ae-7f96-4695-979d-b480043d5d77
                ©András Lánczky, Balázs Győrffy. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 26.07.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 1 February 2021
                : 15 February 2021
                : 19 February 2021
                : 6 May 2021
                Categories
                Original Paper
                Original Paper

                Medicine
                kaplan-meier plot,internet,cox regression,follow-up,multivariate analysis,survival
                Medicine
                kaplan-meier plot, internet, cox regression, follow-up, multivariate analysis, survival

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