A semiparametric additive rates model for the weighted composite endpoint of recurrent and terminal events

Lifetime Data Analysis - Recurrent event data with a terminal event commonly arise in longitudinal follow-up studies. We use a weighted composite endpoint of all recurrent and terminal events to...     

Stratified proportional subdistribution hazards model with covariate-adjusted censoring weight for case-cohort studies

The case-cohort study design is widely used to reduce cost when collecting expensive covariates in large cohort studies with survival or competing risks outcomes. A case-cohort study dataset consists of two parts: (a) a random sample and (b) all cases or failures from a specific cause of interest. Clinicians often assess covariate effects on competing risks outcomes. The proportional subdistribution hazards model directly evaluates the effect of a covariate on the cumulative incidence function under the non-covariate-dependent censoring assumption for the full cohort study. However, the non-covariate-dependent censoring assumption is often violated in many biomedical studies. In this article, we propose a proportional subdistribution hazards model for case-cohort studies with stratified data with covariate-adjusted censoring weight. We further propose an efficient estimator when extra information from the other causes is available under case-cohort studies. The proposed estimators are shown to be consistent and asymptotically normal. Simulation studies show (a) the proposed estimator is unbiased when the censoring distribution depends on covariates and (b) the proposed efficient estimator gains estimation efficiency when using extra information from the other causes. We analyze a bone marrow transplant dataset and a coronary heart disease dataset using the proposed method.     

A varying-coefficient model for gap times between recurrent events

Lifetime Data Analysis - Recurrent events often arise in follow-up studies where a subject may experience multiple occurrences of the same type of event. Most regression models for recurrent events...     

A semiparametric additive rates model for recurrent event data

Recurrent event data often arise in biomedical studies, with examples including hospitalizations, infections, and treatment failures. In observational studies, it is often of interest to estimate the effects of covariates on the marginal recurrent event rate. The majority of existing rate regression methods assume multiplicative covariate effects. We propose a semiparametric model for the marginal recurrent event rate, wherein the covariates are assumed to add to the unspecified baseline rate. Covariate effects are summarized by rate differences, meaning that the absolute effect on the rate function can be determined from the regression coefficient alone. We describe modifications of the proposed method to accommodate a terminating event (e.g., death). Proposed estimators of the regression parameters and baseline rate are shown to be consistent and asymptotically Gaussian. Simulation studies demonstrate that the asymptotic approximations are accurate in finite samples. The proposed methods are applied to a state-wide kidney transplant data set.     

Sample size calculation for recurrent events data in one‐arm studies

In some exceptional circumstances, as in very rare diseases, nonrandomized one‐arm trials are the sole source of evidence to demonstrate efficacy and safety of a new treatment. The design of such studies needs a sound methodological approach in order to provide reliable information, and the determination of the appropriate sample size still represents a critical step of this planning process. As, to our knowledge, no method exists for sample size calculation in one‐arm trials with a recurrent event endpoint, we propose here a closed sample size formula. It is derived assuming a mixed Poisson process, and it is based on the asymptotic distribution of the one‐sample robust nonparametric test recently developed for the analysis of recurrent events data. The validity of this formula in managing a situation with heterogeneity of event rates, both in time and between patients, and time‐varying treatment effect was demonstrated with exhaustive simulation studies. Moreover, although the method requires the specification of a process for events generation, it seems to be robust under erroneous definition of this process, provided that the number of events at the end of the study is similar to the one assumed in the planning phase. The motivating clinical context is represented by a nonrandomized one‐arm study on gene therapy in a very rare immunodeficiency in children (ADA‐SCID), where a major endpoint is the recurrence of severe infections. Copyright © 2012 John Wiley & Sons, Ltd.     

Joint model for bivariate zero-inflated recurrent event data with terminal events

Bivariate recurrent event data are observed when subjects are at risk of experiencing two different type of recurrent events. In this paper, our interest is to suggest statistical model when there is a substantial portion of subjects not experiencing recurrent events but having a terminal event. In a context of recurrent event data, zero events can be related with either the risk free group or a terminal event. For simultaneously reflecting both a zero inflation and a terminal event in a context of bivariate recurrent event data, a joint model is implemented with bivariate frailty effects. Simulation studies are performed to evaluate the suggested models. Infection data from AML (acute myeloid leukemia) patients are analyzed as an application.     

An additive-multiplicative rates model for recurrent event data with informative terminal event

In this article, we propose an additive-multiplicative rates model for recurrent event data in the presence of a terminal event such as death. The association between recurrent and terminal events is nonparametric. For inference on the model parameters, estimating equation approaches are developed, and the asymptotic properties of the resulting estimators are established. The finite sample behavior of the proposed estimators is evaluated through simulation studies, and an application to a bladder cancer study is provided.     

Semiparametric inference for the recurrent events process by means of a single-index model

In this paper, we introduce new parametric and semiparametric regression techniques for a recurrent event process subject to random right censoring. We develop models for the cumulative mean function and provide asymptotically normal estimators. Our semiparametric model which relies on a single-index assumption can be seen as a dimension reduction technique that, contrary to a fully nonparametric approach, is not stroke by the curse of dimensionality when the number of covariates is high. We discuss data-driven techniques to choose the parameters involved in the estimation procedures and provide a simulation study to support our theoretical results.     

Use of multiple imputation in supersampled nested case-control and case-cohort studies

Nested case-control and case-cohort studies are useful for studying associations between covariates and time-to-event when some covariates are expensive to measure. Full covariate information is collected in the nested case-control or case-cohort sample only, while cheaply measured covariates are often observed for the full cohort. Standard analysis of such case-control samples ignores any full cohort data. Previous work has shown how data for the full cohort can be used efficiently by multiple imputation of the expensive covariate(s), followed by a full-cohort analysis. For large cohorts this is computationally expensive or even infeasible. An alternative is to supplement the case-control samples with additional controls on which cheaply measured covariates are observed. We show how multiple imputation can be used for analysis of such supersampled data. Simulations show that this brings efficiency gains relative to a traditional analysis and that the efficiency loss relative to using the full cohort data is not substantial.     

A joint modelling approach for clustered recurrent events and death events

In dental implant research studies, events such as implant complications including pain or infection may be observed recurrently before failure events, i.e. the death of implants. It is natural to assume that recurrent events and failure events are correlated to each other, since they happen on the same implant (subject) and complication times have strong effects on the implant survival time. On the other hand, each patient may have more than one implant. Therefore these recurrent events or failure events are clustered since implant complication times or failure times within the same patient (cluster) are likely to be correlated. The overall implant survival times and recurrent complication times are both interesting to us. In this paper, a joint modelling approach is proposed for modelling complication events and dental implant survival times simultaneously. The proposed method uses a frailty process to model the correlation within cluster and the correlation within subjects. We use Bayesian methods to obtain estimates of the parameters. Performance of the joint models are shown via simulation studies and data analysis.     

Regression analysis of case-cohort studies in the presence of dependent interval censoring

The case-cohort design is widely used as a means of reducing the cost in large cohort studies, especially when the disease rate is low and covariate measurements may be expensive, and has been discussed by many authors. In this paper, we discuss regression analysis of case-cohort studies that produce interval-censored failure time with dependent censoring, a situation for which there does not seem to exist an established approach. For inference, a sieve inverse probability weighting estimation procedure is developed with the use of Bernstein polynomials to approximate the unknown baseline cumulative hazard functions. The proposed estimators are shown to be consistent and the asymptotic normality of the resulting regression parameter estimators is established. A simulation study is conducted to assess the finite sample properties of the proposed approach and indicates that it works well in practical situations. The proposed method is applied to an HIV/AIDS case-cohort study that motivated this investigation.     

Additive risk model with case-cohort sampled current status data

Two-phase stratified sampling has been extensively used in large epidemiologic studies as a way of reducing costs associated with assembling covariate histories and enlarging relative sample sizes of the most informative subgroups. In this article, we investigate case-cohort sampled current status data under the additive risk model assumption. We describe a class of estimating equations, each depending on a different prevalence ratio estimate. Asymptotic properties of the proposed estimators and inference based on the “m out of n” nonparametric bootstrap are investigated. A small simulation study is employed to evaluate the finite sample performance and relative efficiency of the proposed estimators.     

Modeling marginal features in studies of recurrent events in the presence of a terminal event

We study models for recurrent events with special emphasis on the situation where a terminal event acts as a competing risk for the recurrent events process and where there may be gaps between periods during which subjects are at risk for the recurrent event. We focus on marginal analysis of the expected number of events and show that an Aalen–Johansen type estimator proposed by Cook and Lawless is applicable in this situation. A motivating example deals with psychiatric hospital admissions where we supplement with analyses of the marginal distribution of time to the competing event and the marginal distribution of the time spent in hospital. Pseudo-observations are used for the latter purpose.

     

Partial sufficient dimension reduction on joint model of recurrent and terminal events

Joint modeling of recurrent and terminal events has attracted considerable interest and extensive investigations by many authors. The assumption of low-dimensional covariates has been usually applied in the existing studies, which is however inapplicable in many practical situations. In this paper, we consider a partial sufficient dimension reduction approach for a joint model with high-dimensional covariates. Some simulations as well as three real data applications are presented to confirm and assess the performance of the proposed model and approach.     

A class of goodness-of-fit test for the additive hazards model with case-cohort data

The case-cohort design is commonly used in epidemiological studies due to its cost-effectiveness. The additive hazards model is widely used in survival analysis when the hazards difference is constant. In this article, we propose a class of goodness-of-fit test statistics for the assumption of the additive hazards model with case-cohort data through a class of asymptotically mean-zero multiparameter stochastic processes. We also establish the asymptotic theory of the proposed test statistics and a resampling scheme is adopted to approximate its asymptotic distribution. The performance of the proposed test statistics is evaluated through simulation studies and a real dataset is analyzed to illustrate the proposed method.     

Causal inference for recurrent events data with all-or-none compliance

ABSTRACT

In this article, causal inference in randomized studies with recurrent events data and all-or-none compliance is considered. We use the counting process to analyze the recurrent events data and propose a causal proportional intensity model. The maximum likelihood approach is adopted to estimate the parameters of the proposed causal model. To overcome the computational difficulties created by the mixture structure of the problem, we develop an expectation-maximization (EM) algorithm. The resulting estimators are shown to be consistent and asymptotically normal. We further estimate the complier average causal effect (CACE), which is defined as the difference of the average numbers of recurrence between treatment and control groups within the complier class. The corresponding inferential procedures are established. Some simulation studies are conducted to assess the finite sample performance of the proposed approach.     

Statistical inference for generalized case-cohort design under the proportional hazards model with parameter constraints

ABSTRACT

The generalized case-cohort design is widely used in large cohort studies to reduce the cost and improve the efficiency. Taking prior information of parameters into consideration in modeling process can further raise the inference efficiency. In this paper, we consider fitting proportional hazards model with constraints for generalized case-cohort studies. We establish a working likelihood function for the estimation of model parameters. The asymptotic properties of the proposed estimator are derived via the Karush-Kuhn-Tucker conditions, and their finite properties are assessed by simulation studies. A modified minorization-maximization algorithm is developed for the numerical calculation of the constrained estimator. An application to a Wilms tumor study demonstrates the utility of the proposed method in practice.     

Asymptotic results for fitting marginal hazards models from stratified case-cohort studies with multiple disease outcomes

In stratified case-cohort designs, samplings of case-cohort samples are conducted via a stratified random sampling based on covariate information available on the entire cohort members. In this paper, we extended the work of Kang & Cai (2009) to a generalized stratified case-cohort study design for failure time data with multiple disease outcomes. Under this study design, we developed weighted estimating procedures for model parameters in marginal multiplicative intensity models and for the cumulative baseline hazard function. The asymptotic properties of the estimators are studied using martingales, modern empirical process theory, and results for finite population sampling.     

A regularized variable selection procedure in additive hazards model with stratified case-cohort design

Case-cohort designs are commonly used in large epidemiological studies to reduce the cost associated with covariate measurement. In many such studies the number of covariates is very large. An efficient variable selection method is needed for case-cohort studies where the covariates are only observed in a subset of the sample. Current literature on this topic has been focused on the proportional hazards model. However, in many studies the additive hazards model is preferred over the proportional hazards model either because the proportional hazards assumption is violated or the additive hazards model provides more relevent information to the research question. Motivated by one such study, the Atherosclerosis Risk in Communities (ARIC) study, we investigate the properties of a regularized variable selection procedure in stratified case-cohort design under an additive hazards model with a diverging number of parameters. We establish the consistency and asymptotic normality of the penalized estimator and prove its oracle property. Simulation studies are conducted to assess the finite sample performance of the proposed method with a modified cross-validation tuning parameter selection methods. We apply the variable selection procedure to the ARIC study to demonstrate its practical use.     

Event dependent sampling of recurrent events

The effect of event-dependent sampling of processes consisting of recurrent events is investigated when analyzing whether the risk of recurrence increases with event count. We study the situation where processes are selected for study if an event occurs in a certain selection interval. Motivation comes from psychiatric epidemiology where repeated hospital admissions are studied for patients with affective disease, as seen in Kessing et al. (Acta Psychiatr Scand 109:339–344, 2004b). For the selected processes, either only disease course from selection and onwards is used in the analysis, or, both retrospective and prospective disease course histories are used. We examine two methods to correct for the selection depending on which data are used in the analysis. In the first case, the conditional distribution of the process given the pre-selection history is determined. In the second case, an inverse-probability-of-selection weighting scheme is suggested. The ability of the methods to correct for the bias due to selection is investigated with simulations. Furthermore, the methods are applied to affective disease data from a register-based study (Kessing et al. Br J Psychiatry 185:372–377, 2004a) and from a long-term clinical study (Kessing et al. Acta Psychiatr Scand 109:339–344, 2004b).