arXiv subjects

Stefan Fröhling

Publications and source records attributed to Stefan Fröhling.

3 recordsLinked to original sources

arXiv2026

DNA Methylation Profiling in Melanoma: From Lesion Classification to Therapeutic Stratification

DNA methylation provides a stable record of cellular identity, capturing epigenetic programs that distinguish specialized cell states despite a shared genome. Because malignant transformation and tumour progression are accompanied by extensive epigenetic remodeling, we hypothesized that the methylome of melanocytic lesions contains biologically and clinically relevant information for both diagnosis and disease progression. In a cohort of 1,001 tissue samples prospectively collected across eight German university hospitals profiled using Illumina Infinium MethylationEPIC arrays, we compared machine-learning models based on selected Cytosine phosphate Guanine (CpG) methylation sites with models incorporating biology-guided features, including epigenetic age acceleration, cell type composition and copy-number variation burden. In an external test set, the best diagnostic classifier was CpG-based and distinguished melanocytic nevi, noninvasive melanoma and invasive melanoma with a macro-averaged area under the receiver operating characteristic curve of 0.919 (95% CI: 0.878 to 0.952). Notably, across CpGs most strongly hyper- and hypomethylated between NV and IM, NIM showed an intermediate methylation profile, providing a molecular correlate of its diagnostic complexity. The best model for clinically relevant treatment group prediction, with AJCC stages grouped according to guideline-based management recommendations, relied on biology-guided features and achieved a macro-averaged mean absolute error of 0.627 (95% CI: 0.477 to 0.808). Together, these findings demonstrate that methylation-based models can capture both diagnostic identity and clinically relevant disease stratification, supporting DNA methylation as a promising biomarker for further validation and potential clinical translation.

q-bio.GN↗

arXiv2025

Effect measures for comparing paired event times

The progression-free survival ratio (PFSr) is a widely used measure in personalized oncology trials. It evaluates the effectiveness of treatment by comparing two consecutive event times - one under standard therapy and one under an experimental treatment. However, most proposed tests based on the PFSr cannot control the nominal type I error rate, even under mild assumptions such as random right-censoring. Consequently the results of these tests are often unreliable. As a remedy, we propose to estimate the relevant probabilities related to the PFSr by adapting recently developed methodology for the relative treatment effect between paired event times. As an additional alternative, we develop inference procedures based on differences and ratios of restricted mean survival times. An extensive simulation study confirms that the proposed novel methodology provides reliable inference, whereas previously proposed techniques break down in many realistic settings. The utility of our methods is further illustrated through an analysis of real data from a molecularly aided tumor trial.

stat.ME↗

arXiv2023

Dermatologist-like explainable AI enhances trust and confidence in diagnosing melanoma

Although artificial intelligence (AI) systems have been shown to improve the accuracy of initial melanoma diagnosis, the lack of transparency in how these systems identify melanoma poses severe obstacles to user acceptance. Explainable artificial intelligence (XAI) methods can help to increase transparency, but most XAI methods are unable to produce precisely located domain-specific explanations, making the explanations difficult to interpret. Moreover, the impact of XAI methods on dermatologists has not yet been evaluated. Extending on two existing classifiers, we developed an XAI system that produces text and region based explanations that are easily interpretable by dermatologists alongside its differential diagnoses of melanomas and nevi. To evaluate this system, we conducted a three-part reader study to assess its impact on clinicians' diagnostic accuracy, confidence, and trust in the XAI-support. We showed that our XAI's explanations were highly aligned with clinicians' explanations and that both the clinicians' trust in the support system and their confidence in their diagnoses were significantly increased when using our XAI compared to using a conventional AI system. The clinicians' diagnostic accuracy was numerically, albeit not significantly, increased. This work demonstrates that clinicians are willing to adopt such an XAI system, motivating their future use in the clinic.

q-bio.QM↗