An estimating equation for parametric shared frailty models with marginal additive hazards

Summary.  Multivariate failure time data arise when data consist of clusters in which the failure times may be dependent. A popular approach to such data is the marginal proportional hazards model with estimation under the working independence assumption. In some contexts, however, it may be more reasonable to use the marginal additive hazards model. We derive asymptotic properties of the Lin and Ying estimators for the marginal additive hazards model for multivariate failure time data. Furthermore we suggest estimating equations for the regression parameters and association parameters in parametric shared frailty models with marginal additive hazards by using the Lin and Ying estimators. We give the large sample properties of the estimators arising from these estimating equations and investigate their small sample properties by Monte Carlo simulation. A real example is provided for illustration.     

A Likelihood Based Estimating Equation for the Clayton–Oakes Model with Marginal Proportional Hazards

Multivariate failure time data arise when data consist of clusters in which the failure times may be dependent. A popular approach to such data is the marginal proportional hazards model with estimation under the working independence assumption. In this paper, we consider the Clayton–Oakes model with marginal proportional hazards and use the full model structure to improve on efficiency compared with the independence analysis. We derive a likelihood based estimating equation for the regression parameters as well as for the correlation parameter of the model. We give the large sample properties of the estimators arising from this estimating equation. Finally, we investigate the small sample properties of the estimators through Monte Carlo simulations.     

Analysis of transformation models with right-truncated data

In many applications, statistical data are frequently observed subject to a retrospective sampling criterion resulting in right-truncated data. In this article, a general class of semiparametric transformation models that include proportional hazards model and proportional odds model as special cases is studied for the analysis of right-truncated data. We proposed two estimators for regression coefficients. The first estimator is based on martingale estimating equations. The second estimator is based on the conditional likelihood function given the truncation times. The asymptotic properties of both estimators are derived. The finite sample performance is examined through a simulation study.     

Effects of model misspecification on tests of no randomized treatment effect arising from Cox's proportional hazards model

We examine the asymptotic and small sample properties of model-based and robust tests of the null hypothesis of no randomized treatment effect based on the partial likelihood arising from an arbitrarily misspecified Cox proportional hazards model. When the distribution of the censoring variable is either conditionally independent of the treatment group given covariates or conditionally independent of covariates given the treatment group, the numerators of the partial likelihood treatment score and Wald tests have asymptotic mean equal to 0 under the null hypothesis, regardless of whether or how the Cox model is misspecified. We show that the model-based variance estimators used in the calculation of the model-based tests are not, in general, consistent under model misspecification, yet using analytic considerations and simulations we show that their true sizes can be as close to the nominal value as tests calculated with robust variance estimators. As a special case, we show that the model-based log-rank test is asymptotically valid. When the Cox model is misspecified and the distribution of censoring depends on both treatment group and covariates, the asymptotic distributions of the resulting partial likelihood treatment score statistic and maximum partial likelihood estimator do not, in general, have a zero mean under the null hypothesis. Here neither the fully model-based tests, including the log-rank test, nor the robust tests will be asymptotically valid, and we show through simulations that the distortion to test size can be substantial.     

Proportional cause-specific reversed hazards model

The proportional reversed hazards model explains the multiplicative effect of covariates on the baseline reversed hazard rate function of lifetimes. In the present study, we introduce a proportional cause-specific reversed hazards model. The proposed regression model facilitates the analysis of failure time data with multiple causes of failure under left censoring. We estimate the regression parameters using a partial likelihood approach. We provide Breslow's type estimators for the cumulative cause-specific reversed hazard rate functions. Asymptotic properties of the estimators are discussed. Simulation studies are conducted to assess their performance. We illustrate the applicability of the proposed model using a real data set.     

Generating data from improper distributions: application to Cox proportional hazards models with cure

Cure rate models are survival models characterized by improper survivor distributions which occur when the cumulative distribution function, say F, of the survival times does not sum up to 1 (i.e. F(+∞)<1). The first objective of this paper is to provide a general approach to generate data from any improper distribution. An application to times to event data randomly drawn from improper distributions with proportional hazards is investigated using the semi-parametric proportional hazards model with cure obtained as a special case of the nonlinear transformation models in [Tsodikov, Semiparametric models: A generalized self-consistency approach, J. R. Stat. Soc. Ser. B 65 (2003), pp. 759–774]. The second objective of this paper is to show by simulations that the bias, the standard error and the mean square error of the maximum partial likelihood (PL) estimator of the hazard ratio as well as the statistical power based on the PL estimator strongly depend on the proportion of subjects in the whole population who will never experience the event of interest.     

Marginal Regression of Gaps Between Recurrent Events

Recurrent event data typically exhibit the phenomenon of intra-individual correlation, owing to not only observed covariates but also random effects. In many applications, the population may be reasonably postulated as a heterogeneous mixture of individual renewal processes, and the inference of interest is the effect of individual-level covariates. In this article, we suggest and investigate a marginal proportional hazards model for gaps between recurrent events. A connection is established between observed gap times and clustered survival data with informative cluster size. We subsequently construct a novel and general inference procedure for the latter, based on a functional formulation of standard Cox regression. Large-sample theory is established for the proposed estimators. Numerical studies demonstrate that the procedure performs well with practical sample sizes. Application to the well-known bladder tumor data is given as an illustration.     

Maximum Likelihood Estimations and EM Algorithms with Length-biased Data

Length-biased sampling has been well recognized in economics, industrial reliability, etiology applications, epidemiological, genetic and cancer screening studies. Length-biased right-censored data have a unique data structure different from traditional survival data. The nonparametric and semiparametric estimations and inference methods for traditional survival data are not directly applicable for length-biased right-censored data. We propose new expectation-maximization algorithms for estimations based on full likelihoods involving infinite dimensional parameters under three settings for length-biased data: estimating nonparametric distribution function, estimating nonparametric hazard function under an increasing failure rate constraint, and jointly estimating baseline hazards function and the covariate coefficients under the Cox proportional hazards model. Extensive empirical simulation studies show that the maximum likelihood estimators perform well with moderate sample sizes and lead to more efficient estimators compared to the estimating equation approaches. The proposed estimates are also more robust to various right-censoring mechanisms. We prove the strong consistency properties of the estimators, and establish the asymptotic normality of the semi-parametric maximum likelihood estimators under the Cox model using modern empirical processes theory. We apply the proposed methods to a prevalent cohort medical study. Supplemental materials are available online.     

Small sample confidence intervals for survival functions under the proportional hazards model

We develop a saddlepoint-based method for generating small sample confidence bands for the population surviival function from the Kaplan-Meier (KM), the product limit (PL), and Abdushukurov-Cheng-Lin (ACL) survival function estimators, under the proportional hazards model. In the process we derive the exact distribution of these estimators and developed mid-ppopulation tolerance bands for said estimators. Our saddlepoint method depends upon the Mellin transform of the zero-truncated survival estimator which we derive for the KM, PL, and ACL estimators. These transforms are inverted via saddlepoint approximations to yield highly accurate approximations to the cumulative distribution functions of the respective cumulative hazard function estimators and these distribution functions are then inverted to produce our saddlepoint confidence bands. For the KM, PL and ACL estimators we compare our saddlepoint confidence bands with those obtained from competing large sample methods as well as those obtained from the exact distribution. In our simulation studies we found that the saddlepoint confidence bands are very close to the confidence bands derived from the exact distribution, while being much easier to compute, and outperform the competing large sample methods in terms of coverage probability.     

Proportional hazards models based on biased samples and estimated selection probabilities

In non‐randomized biomedical studies using the proportional hazards model, the data often constitute an unrepresentative sample of the underlying target population, which results in biased regression coefficients. The bias can be avoided by weighting included subjects by the inverse of their respective selection probabilities, as proposed by Horvitz & Thompson (1952) and extended to the proportional hazards setting for use in surveys by Binder (1992) and Lin (2000). In practice, the weights are often estimated and must be treated as such in order for the resulting inference to be accurate. The authors propose a two‐stage weighted proportional hazards model in which, at the first stage, weights are estimated through a logistic regression model fitted to a representative sample from the target population. At the second stage, a weighted Cox model is fitted to the biased sample. The authors propose estimators for the regression parameter and cumulative baseline hazard. They derive the asymptotic properties of the parameter estimators, accounting for the difference in the variance introduced by the randomness of the weights. They evaluate the accuracy of the asymptotic approximations in finite samples through simulation. They illustrate their approach in an analysis of renal transplant patients using data obtained from the Scientific Registry of Transplant Recipients     

Nonparametric analysis of recurrent gap time data

Abstract

Recurrent event data are frequently encountered in longitudinal studies. In many applications, the times between successive recurrent events (gap times) are often of interest and lead to problems that have received much attention recently. In this article, using the approach of inverse probability-of-censoring weights (IPCW), we propose nonparametric estimators for the estimation of the bivariate distribution and survival functions for gap times of recurrent event data. We also consider the estimation of Kendall’s tau for two gap times by expressing it as an integral functional of the bivariate survival function. The asymptotic properties of the proposed estimators are established. Simulation studies are conducted to investigate their finite sample performance.     

Estimation in a model for a semi-Markov process with covariates under right-censoring

A semi-Markov model with covariates is proposed for a multi-state process with a finite number of states such that the transition probabilities between the states and the distribution functions of the duration times between the occurrence of two states depend on a discrete covariate. The hazard rates for the time elapsed between two successive states depend on the covariate through a proportional hazards model involving a set of regression parameters, while the transition probabilities depend on the covariate in an unspecified way. We propose estimators for these parameters and for the cumulative hazard functions of the sojourn times. A difficulty comes from the fact that when a sojourn time in a state is right-censored, the next state is unknown. We prove that our estimators are consistent and asymptotically Gaussian under the model constraints.     

Semiparametric inference of proportional odds model based on randomly truncated data

This paper studies the estimation in the proportional odds model based on randomly truncated data. The proposed estimators for the regression coefficients include a class of minimum distance estimators defined through weighted empirical odds function. We have investigated the asymptotic properties like the consistency and the limiting distribution of the proposed estimators under mild conditions. The finite sample properties were investigated through simulation study making comparison of some of the estimators in the class. We conclude with an illustration of our proposed method to a well-known AIDS data.     

Small sample study on estimators of life distributions and of mean survival times using randomly censored data

Whereas large-sample properties of the estimators of survival distributions using censored data have been studied by many authors, exact results for small samples have been difficult to obtain. In this paper we obtain the exact expression for the ath moment (a > 0) of the Bayes estimator of survival distribution using the censored data under proportional hazard model. Using the exact expression we compute the exact mean, variance and MSE of the Bayes estimator. Also two estimators ofthe mean survival time based on the Kaplan-Meier estimator and the Bayes estimator are compared for small samples under proportional hazards.     

A Semiparametric Regression Method for Interval-Censored Data

In many medical studies, event times are recorded in an interval-censored (IC) format. For example, in numerous cancer trials, time to disease relapse is only known to have occurred between two consecutive clinic visits. Many existing modeling methods in the IC context are computationally intensive and usually require numerous assumptions that could be unrealistic or difficult to verify in practice. We propose a flexible and computationally efficient modeling strategy based on jackknife pseudo-observations (POs). The POs obtained based on nonparametric estimators of the survival function are employed as outcomes in an equivalent, yet simpler regression model that produces consistent covariate effect estimates. Hence, instead of operating in the IC context, the problem is translated into the realm of generalized linear models, where numerous options are available. Outcome transformations via appropriate link functions lead to familiar modeling contexts such as the proportional hazards and proportional odds. Moreover, the methods developed are not limited to these settings and have broader applicability. Simulations studies show that the proposed methods produce virtually unbiased covariate effect estimates, even for moderate sample sizes. An example from the International Breast Cancer Study Group (IBCSG) Trial VI further illustrates the practical advantages of this new approach.     

Analysis of error-prone survival data under additive hazards models: measurement error effects and adjustments

Covariate measurement error occurs commonly in survival analysis. Under the proportional hazards model, measurement error effects have been well studied, and various inference methods have been developed to correct for error effects under such a model. In contrast, error-contaminated survival data under the additive hazards model have received relatively less attention. In this paper, we investigate this problem by exploring measurement error effects on parameter estimation and the change of the hazard function. New insights of measurement error effects are revealed, as opposed to well-documented results for the Cox proportional hazards model. We propose a class of bias correction estimators that embraces certain existing estimators as special cases. In addition, we exploit the regression calibration method to reduce measurement error effects. Theoretical results for the developed methods are established, and numerical assessments are conducted to illustrate the finite sample performance of our methods.     

Cox regression of clustered event times with covariates missing not at random

Motivated by a recent tuberculosis (TB) study, this paper is concerned with covariates missing not at random (MNAR) and models the potential intracluster correlation by a frailty. We consider the regression analysis of right‐censored event times from clustered subjects under a Cox proportional hazards frailty model and present the semiparametric maximum likelihood estimator (SPMLE) of the model parameters. An easy‐to‐implement pseudo‐SPMLE is then proposed to accommodate more realistic situations using readily available supplementary information on the missing covariates. Algorithms are provided to compute the estimators and their consistent variance estimators. We demonstrate that both the SPMLE and the pseudo‐SPMLE are consistent and asymptotically normal by the arguments based on the theory of modern empirical processes. The proposed approach is examined numerically via simulation and illustrated with an analysis of the motivating TB study data.     

Proportional hazards regression for cancer screening data

The complication in analysing tumour data is that the tumours detected in a screening programme tend to be slowly progressive, which is the so-called left-truncated sampling that is inherent in screening studies. Under the assumption that all subjects have the same tumour growth function, Ghosh [Proportional hazards regression for cancer studies, Biometrics 64 (2008), pp. 141–148] developed estimation procedures for proportional hazards model. In this note, by modelling growth function as a function of covariates and parameterizing the distribution function of left truncation time, we demonstrate that Ghosh's approach can be extended to the case when each subject has a specific growth function. A simulation study is conducted to demonstrate the potential usefulness of the proposed estimators for the regression parameters in the proportional hazards model.     

A note on the asymptotic relative efficiency of estimators from the additive hazards model

In this note, the asymptotic variance formulas are explicitly derived and compared between the parametric and semiparametric estimators of a regression parameter and survival probability under the additive hazards model. To obtain explicit formulas, it is assumed that the covariate term including a regression coefficient follows a gamma distribution and the baseline hazard function is constant. The results show that the semiparametric estimator of the regression coefficient parameter is fully efficient relative to the parametric counterpart when the survival time and a covariate are independent, as in the proportional hazards model. Relative to a more realistic case of the parametric additive hazards model with a Weibull baseline, the loss of efficiency of the semiparametric estimator of survival probability is moderate.     

An Estimator of the Survival Function Basedon the Semi-Markov Model Under Dependent Censorship

Lee and Wolfe (Biometrics vol. 54 pp. 1176–1178, 1998) proposed the two-stage sampling design for testing the assumption of independent censoring, which involves further follow-up of a subset of lost-to-follow-up censored subjects. They also proposed an adjusted estimator for the survivor function for a proportional hazards model under the dependent censoring model. In this paper, a new estimator for the survivor function is proposed for the semi-Markov model under the dependent censorship on the basis of the two-stage sampling data. The consistency and the asymptotic distribution of the proposed estimator are derived. The estimation procedure is illustrated with an example of lung cancer clinical trial and simulation results are reported of the mean squared errors of estimators under a proportional hazards and two different nonproportional hazards models.