A semi-Markov model for survival data with covariates

Clinical trials are often concerned with the evaluation of two or more time-dependent stochastic events and their relationship. The information on covariates for individuals in the studies is valuable in assessing the survival function. This paper develops a multistate stochastic survival model which incorporates covariates. It is assumed that the underlying process follows a semi-Markov model. The proportional hazards techniques are applied to estimate the force of transition in the process. The maximum likelihood estimators are derived along with the survival function for competing risks problems. An application is given to analyzing the survival of patients in the Stanford Heart Transplant Program.     

Estimation with correlated censored survival data with missing covariates

Incomplete covariate data are a common occurrence in studies in which the outcome is survival time. Further, studies in the health sciences often give rise to correlated, possibly censored, survival data. With no missing covariate data, if the marginal distributions of the correlated survival times follow a given parametric model, then the estimates using the maximum likelihood estimating equations, naively treating the correlated survival times as independent, give consistent estimates of the relative risk parameters Lipsitz et al. 1994 50, 842-846. Now, suppose that some observations within a cluster have some missing covariates. We show in this paper that if one naively treats observations within a cluster as independent, that one can still use the maximum likelihood estimating equations to obtain consistent estimates of the relative risk parameters. This method requires the estimation of the parameters of the distribution of the covariates. We present results from a clinical trial Lipsitz and Ibrahim (1996b) 2, 5-14 with five covariates, four of which have some missing values. In the trial, the clusters are the hospitals in which the patients were treated.     

Parametric survival models for interval-censored data with time-dependent covariates

We present a parametric family of regression models for interval-censored event-time (survival) data that accomodates both fixed (e.g. baseline) and time-dependent covariates. The model employs a three-parameter family of survival distributions that includes the Weibull, negative binomial, and log-logistic distributions as special cases, and can be applied to data with left, right, interval, or non-censored event times. Standard methods, such as Newton-Raphson, can be employed to estimate the model and the resulting estimates have an asymptotically normal distribution about the true values with a covariance matrix that is consistently estimated by the information function. The deviance function is described to assess model fit and a robust sandwich estimate of the covariance may also be employed to provide asymptotically robust inferences when the model assumptions do not apply. Spline functions may also be employed to allow for non-linear covariates. The model is applied to data from a long-term study of type 1 diabetes to describe the effects of longitudinal measures of glycemia (HbA1c) over time (the time-dependent covariate) on the risk of progression of diabetic retinopathy (eye disease), an interval-censored event-time outcome.     

Doubly penalized buckley-james method for survival data with high-dimensional covariates.

Recent interest in cancer research focuses on predicting patients' survival by investigating gene expression profiles based on microarray analysis. We propose a doubly penalized Buckley-James method for the semiparametric accelerated failure time model to relate high-dimensional genomic data to censored survival outcomes, which uses the elastic-net penalty that is a mixture of L1- and L2-norm penalties. Similar to the elastic-net method for a linear regression model with uncensored data, the proposed method performs automatic gene selection and parameter estimation, where highly correlated genes are able to be selected (or removed) together. The two-dimensional tuning parameter is determined by generalized crossvalidation. The proposed method is evaluated by simulations and applied to the Michigan squamous cell lung carcinoma study.     

Marginal modeling of multilevel binary data with time-varying covariates

We propose and compare two approaches for regression analysis of multilevel binary data when clusters are not necessarily nested: a GEE method that relies on a working independence assumption coupled with a three-step method for obtaining empirical standard errors, and a likelihood-based method implemented using Bayesian computational techniques. Implications of time-varying endogenous covariates are addressed. The methods are illustrated using data from the Breast Cancer Surveillance Consortium to estimate mammography accuracy from a repeatedly screened population.     

A simple EM algorithm for capture-recapture data with categorical covariates

A simple EM algorithm is proposed for obtaining maximum likelihood estimates when fitting a loglinear model to data from k capture-recapture samples with categorical covariates. The method is used to analyze data on screening for the early detection of breast cancer.     

A sampling study of the size and power of tests for paired survival data

The paired-t, sign, and signed rank tests were compared for samples from a bivariate exponential distribution. Each is a valid α-level test. One test was not uniformly more powerful than the others for all sample sizes, α levels, correlations, and alternative hypotheses considered, but the signed rank test did well consistently. It was always preferable to the sign test and never was appreciably worse than the paired-t test. The relative performance of the tests depends on α as well as the sample size.     

A semiparametric approach for the nonparametric transformation survival model with multiple covariates

The nonparametric transformation model makes no parametric assumptions on the forms of the transformation function and the error distribution. This model is appealing in its flexibility for modeling censored survival data. Current approaches for estimation of the regression parameters involve maximizing discontinuous objective functions, which are numerically infeasible to implement with multiple covariates. Based on the partial rank (PR) estimator (Khan and Tamer, 2004), we propose a smoothed PR estimator which maximizes a smooth approximation of the PR objective function. The estimator is shown to be asymptotically equivalent to the PR estimator but is much easier to compute when there are multiple covariates. We further propose using the weighted bootstrap, which is more stable than the usual sandwich technique with smoothing parameters, for estimating the standard error. The estimator is evaluated via simulation studies and illustrated with the Veterans Administration lung cancer data set.     

Attenuation caused by infrequently updated covariates in survival analysis

This paper deals with hazard regression models for survival data with time-dependent covariates consisting of updated quantitative measurements. The main emphasis is on the Cox proportional hazards model but also additive hazard models are discussed. Attenuation of regression coefficients caused by infrequent updating of covariates is evaluated using simulated data mimicking our main example, the CSL1 liver cirrhosis trial. We conclude that the degree of attenuation depends on the type of stochastic process describing the time-dependent covariate and that attenuation may be substantial for an Ornstein-Uhlenbeck process. Also trends in the covariate combined with non-synchronous updating may cause attenuation. Simple methods to adjust for infrequent updating of covariates are proposed and compared to existing techniques using both simulations and the CSL1 data. The comparison shows that while existing, more complicated methods may work well with frequent updating of covariates the simpler techniques may have advantages in larger data sets with infrequent updatings.     

Modelling the effects of partially observed covariates on Poisson process intensity

We propose an estimating function for parameters in a modelfor Poisson process intensity when time- or space-varying covariatesare observed for both the events of the process and at sampletimes or locations selected from a probability-based samplingdesign. We investigate the large-sample properties of the proposedestimator under increasing domain asymptotics, demonstratingthat it is consistent and asymptotically normally distributed.We illustrate our approach using data from an ecological momentaryassessment of smoking.