Case-cohort designs and analysis for clustered failure time data

Case-cohort design is an efficient and economical design to study risk factors for infrequent disease in a large cohort. It involves the collection of covariate data from all failures ascertained throughout the entire cohort, and from the members of a random subcohort selected at the onset of follow-up. In the literature, the case-cohort design has been extensively studied, but was exclusively considered for univariate failure time data. In this article, we propose case-cohort designs adapted to multivariate failure time data. An estimation procedure with the independence working model approach is used to estimate the regression parameters in the marginal proportional hazards model, where the correlation structure between individuals within a cluster is left unspecified. Statistical properties of the proposed estimators are developed. The performance of the proposed estimators and comparisons of statistical efficiencies are investigated with simulation studies. A data example from the Translating Research into Action for Diabetes (TRIAD) study is used to illustrate the proposed methodology.     

Application of the Principal Components Method and the Proportional Hazards Regression Model to Analysis of Survival Data

One of factor analysis techniques, viz. the principal components method, and the proportional hazards regression model (Cox, 1972) are applied in this work to study the significance of various factors characterizing the patient, the disease, and the method of treatment in the survival. The application of these methods to analysis of survival data for cervical cancer patients has shown, in particular, the tumor growth rate to be the crucial factor in distribution of the patients survival time and to be even more important than the therapy characteristics.     

Analysis of Survival Data with Two Dependent Competing Risks

Here we consider a competing risks model where the two risks of interest are not independent. The dependence is due to the additive effect of an independent contaminating risk on two initially independent risks. The problem is identifiable when the three risks fllow independent exponential distributions and also when the two initial risks follow proportional hazards model. Procedures are suggested for estimation and testing hypotheses regarding the parameters of the three exponentials in the first can and the constant of proportionality in the second case, when the information available consists of the times to death and the causes of death of the individuals.     

A parametric model for studying organism fitness using step-stress experiments

We propose a method based on parametric survival analysis to analyze step-stress data. Step-stress studies are failure time studies in which the experimental stressor is increased at specified time intervals. While this protocol has been frequently employed in industrial reliability studies, it is less common in the life sciences. Possible biological applications include experiments on swimming performance of fish using a step function defining increasing water velocity over time, and treadmill tests on humans. A likelihood-ratio test is developed for comparing the failure times in two groups based on a piecewise constant hazard assumption. The test can be extended to other piecewise distributions and to include covariates. An example data set is used to illustrate the method and highlight experimental design issues. A small simulation study compares this analysis procedure to currently used methods with regard to type I error rate and power.     

Semiparametric regression analysis of interval-censored data

We propose a semiparametric approach to the proportional hazards regression analysis of interval-censored data. An EM algorithm based on an approximate likelihood leads to an M-step that involves maximizing a standard Cox partial likelihood to estimate regression coefficients and then using the Breslow estimator for the unknown baseline hazards. The E-step takes a particularly simple form because all incomplete data appear as linear terms in the complete-data log likelihood. The algorithm of Turnbull (1976, Journal of the Royal Statistical Society, Series B 38, 290-295) is used to determine times at which the hazard can take positive mass. We found multiple imputation to yield an easily computed variance estimate that appears to be more reliable than asymptotic methods with small to moderately sized data sets. In the right-censored survival setting, the approach reduces to the standard Cox proportional hazards analysis, while the algorithm reduces to the one suggested by Clayton and Cuzick (1985, Applied Statistics 34, 148-156). The method is illustrated on data from the breast cancer cosmetics trial, previously analyzed by Finkelstein (1986, Biometrics 42, 845-854) and several subsequent authors.     

Regression analysis of a disease onset distribution using diagnosis data

Summary .   We consider methods for estimating the effect of a covariate on a disease onset distribution when the observed data structure consists of right-censored data on diagnosis times and current status data on onset times amongst individuals who have not yet been diagnosed. Dunson and Baird (2001, Biometrics 57, 306–403) approached this problem using maximum likelihood, under the assumption that the ratio of the diagnosis and onset distributions is monotonic nondecreasing. As an alternative, we propose a two-step estimator, an extension of the approach of van der Laan, Jewell, and Petersen (1997, Biometrika 84, 539–554) in the single sample setting, which is computationally much simpler and requires no assumptions on this ratio. A simulation study is performed comparing estimates obtained from these two approaches, as well as that from a standard current status analysis that ignores diagnosis data. Results indicate that the Dunson and Baird estimator outperforms the two-step estimator when the monotonicity assumption holds, but the reverse is true when the assumption fails. The simple current status estimator loses only a small amount of precision in comparison to the two-step procedure but requires monitoring time information for all individuals. In the data that motivated this work, a study of uterine fibroids and chemical exposure to dioxin, the monotonicity assumption is seen to fail. Here, the two-step and current status estimators both show no significant association between the level of dioxin exposure and the hazard for onset of uterine fibroids; the two-step estimator of the relative hazard associated with increasing levels of exposure has the least estimated variance amongst the three estimators considered.     

The mouse: An “average” homeotherm

Mice, rats, and nearly all mammals and birds are classified as homeothermic, meaning that their core temperature is regulated at a constant level over a relatively wide range of ambient temperatures. In one sense, this homeothermic designation has been confirmed by the advent of radiotelemetry and other techniques that allow for the remote monitoring of awake, unrestrained animals in laboratory or natural settings. This technology confirmed that, when averaged over many hours, core temperature of mammals is regulated at a nearly constant level. On the other hand, telemetric sampling in relatively small mammals such as mice and rats also revealed that their core temperature often varies markedly from hour to hour. In other words, the mouse could be defined as a homeotherm only when core temperature is averaged over a relatively long period. Many researchers ascribe equal homeothermic capabilities to mice and other small rodents as they do to humans. Such an assumption could lead to errors in extrapolating physiological, pharmacological, and toxicological findings from experimental test species to humans.     

Nonparametric and semiparametric group sequential methods for comparing accuracy of diagnostic tests

SUMMARY: Comparison of the accuracy of two diagnostic tests using the receiver operating characteristic (ROC) curves from two diagnostic tests has been typically conducted using fixed sample designs. On the other hand, the human experimentation inherent in a comparison of diagnostic modalities argues for periodic monitoring of the accruing data to address many issues related to the ethics and efficiency of the medical study. To date, very little research has been done on the use of sequential sampling plans for comparative ROC studies, even when these studies may use expensive and unsafe diagnostic procedures. In this article we propose a nonparametric group sequential design plan. The nonparametric sequential method adapts a nonparametric family of weighted area under the ROC curve statistics (Wieand et al., 1989, Biometrika 76, 585-592) and a group sequential sampling plan. We illustrate the implementation of this nonparametric approach for sequentially comparing ROC curves in the context of diagnostic screening for nonsmall-cell lung cancer. We also describe a semiparametric sequential method based on proportional hazard models. We compare the statistical properties of the nonparametric approach with alternative semiparametric and parametric analyses in simulation studies. The results show the nonparametric approach is robust to model misspecification and has excellent finite-sample performance.     

Comparison between radiometric and proportional methodologies in susceptibility testing of mycobacteria other than tubercle bacilli (MOT)

109 strains of mycobacteria other than tubercle bacilli (MOT) were tested against four primary antituberculous drugs; 27 strains of M. tuberculosis served as controls. While the latter species showed excellent overall agreement with the reference (proportion) method of Canetti (particularly for sensitive strains), MOTT gave such results only if there was a prevalence of sensitive or resistant strains in a species. Since this could not be predicted, the radiometric method cannot substitute for the proportion method for susceptibility testing of MOTT, in spite of early availability of results.     

Hazard regression for interval-censored data with penalized spline

This article introduces a new approach for estimating the hazard function for possibly interval- and right-censored survival data. We weakly parameterize the log-hazard function with a piecewise-linear spline and provide a smoothed estimate of the hazard function by maximizing the penalized likelihood through a mixed model-based approach. We also provide a method to estimate the amount of smoothing from the data. We illustrate our approach with two well-known interval-censored data sets. Extensive numerical studies are conducted to evaluate the efficacy of the new procedure.     

The quadratic cumulative odds regression model for scored ordinal outcomes: application to alcohol dependence

In this paper, we develop new regression models for the analysis of scored ordinal data (i.e. ordinal outcomes where the categories are assigned numeric values). The novel feature of these models is that they enable one to capture and identify nonlinear aspects of the relationship between an ordinal clinical measurement (used for disease diagnosis) and risk factors. These nonlinearities may be useful in generating hypotheses about the risk factor's role in the etiologic process as well as suggesting how to design future studies of the risk factor. We apply our model to study the effects of race, gender, and family history on alcohol dependence among a cohort of lifetime drinkers from the 1992 National Longitudinal Alcohol Epidemiologic Survey.     

An Asymptotically Optimal Adaptive Selection Procedure in the Proportional Hazards Model with Conditionally Independent Censoring

Assume k independent populations are given which are distributed according to R, …,R (ϑ_i ∈ Θ ⊆ R ). Taking samples of size n the population with the smallest ϑ-value is to be selected. Using the framework of Le Cam's decision theory (Le Cam , 1986; Strasser , 1985) under mild regularity assumptions, an asymptotically optimal selection procedure is derived for the sequence of localized models. In the proportional hazards model with conditionally independent censoring, an asymptotically optimal adaptive selection procedure is constructed by substituting the unknown nuisance parameter by a kernel estimator.     

Relating Cox's Proportional Hazard Model to the Exponential Model for Survival

An approximate representation is given for the partial likelihood estimate of the regression coefficient in Cox's proportional hazard model which indicates how it measures the association between survival time and covariate. The case of a single covariate is concentrated on. The representation is closely related to the first step of a Newton-Raphson iteration, i.e. to the score test. A similar representation for the Feigl-Zelen exponential model shows that a similar type of association is being measured, if observed lifetimes are interpreted as expected lifetimes of ordered exponentials. Necessary and sufficient conditions for the existence of Cox's estimate in the simple case are also written down.     

Adaptive regression splines in the Cox model

We develop a method for constructing adaptive regression spline models for the exploration of survival data. The method combines Cox's (1972, Journal of the Royal Statistical Society, Series B 34, 187-200) regression model with a weighted least-squares version of the multivariate adaptive regressi on spline (MARS) technique of Friedman (1991, Annals of Statistics 19, 1-141) to adaptively select the knots and covariates. The new technique can automatically fit models with terms that represent nonlinear effects and interactions among covariates. Applications based on simulated data and data from a clinical trial for myeloma are presented. Results from the myeloma application identified several important prognostic variables, including a possible nonmonotone relationship with survival in one laboratory variable. Results are compared to those from the adaptive hazard regression (HARE) method of Kooperberg, Stone, and Truong (1995, Journal of the American Statistical Association 90, 78-94).