Each week, we publish layman’s abstracts of new articles from our prestigious portfolio of journals in statistics. The aim is to highlight the latest research to a broader audience in an accessible format.

Simulating the dynamics of atherosclerosis to the incidence of myocardial infarction, applied to the KORA population. Statistics in Medicine. 2021; 40: 3299– 3312. https://doi.org/10.1002/sim.8951
, , , , , . Biological understanding of disease processes steadily improves with time. Nevertheless, little effort has been put so far into harnessing this information to obtain a global quantitative picture of biological processes leading to disease incidence. Such a quantitative link could help understanding and predicting individual risks related to the exposure to risk factors or to disease interventions. However, development of models that relate underlying processes to disease incidence is not an easy task: biological processes are often of complicated random nature, thus impeding analytical treatment.
In this study, the authors show that analytical solvability is not a necessary requirement. They propose a model of atherosclerotic lesion build-up and subsequent myocardial infarction, which is solved only by simulation. The model was constructed to mirror data on atherosclerotic lesions in youth and young adulthood. Flexibility of the simulation approach allowed fitting the model simultaneously to these data and to myocardial infarction incidence rates. The model describes the data appropriately. Interestingly, the fit revealed significant age dependence of parameters in women around the age of menopause, qualitatively reproducing the known vascular effects of female sex hormones.
The proposed simulation approach is very general and versatile. An important aspect is the possibility of direct accounting for data on different stages of disease development. This improves accuracy and reliability, and will do so even more in the future with ever increasing imaging capabilities.