An estimator for the proportional hazards model with multiple longitudinal covariates measured with error

In many longitudinal studies, it is of interest to characterize the relationship between a time-to-event (e.g. survival) and several time-dependent and time-independent covariates. Time-dependent covariates are generally observed intermittently and with error. For a single time-dependent covariate, a popular approach is to assume a joint longitudinal data-survival model, where the time-dependent covariate follows a linear mixed effects model and the hazard of failure depends on random effects and time-independent covariates via a proportional hazards relationship. Regression calibration and likelihood or Bayesian methods have been advocated for implementation; however, generalization to more than one time-dependent covariate may become prohibitive. For a single time-dependent covariate, Tsiatis and Davidian (2001) have proposed an approach that is easily implemented and does not require an assumption on the distribution of the random effects. This technique may be generalized to multiple, possibly correlated, time-dependent covariates, as we demonstrate. We illustrate the approach via simulation and by application to data from an HIV clinical trial.     

Robust best linear estimator for Cox regression with instrumental variables in whole cohort and surrogates with additive measurement error in calibration sample

Biomedical researchers are often interested in estimating the effect of an environmental exposure in relation to a chronic disease endpoint. However, the exposure variable of interest may be measured with errors. In a subset of the whole cohort, a surrogate variable is available for the true unobserved exposure variable. The surrogate variable satisfies an additive measurement error model, but it may not have repeated measurements. The subset in which the surrogate variables are available is called a calibration sample. In addition to the surrogate variables that are available among the subjects in the calibration sample, we consider the situation when there is an instrumental variable available for all study subjects. An instrumental variable is correlated with the unobserved true exposure variable, and hence can be useful in the estimation of the regression coefficients. In this paper, we propose a nonparametric method for Cox regression using the observed data from the whole cohort. The nonparametric estimator is the best linear combination of a nonparametric correction estimator from the calibration sample and the difference of the naive estimators from the calibration sample and the whole cohort. The asymptotic distribution is derived, and the finite sample performance of the proposed estimator is examined via intensive simulation studies. The methods are applied to the Nutritional Biomarkers Study of the Women's Health Initiative.     

Robust best linear estimation for regression analysis using surrogate and instrumental variables

We investigate methods for regression analysis when covariates are measured with errors. In a subset of the whole cohort, a surrogate variable is available for the true unobserved exposure variable. The surrogate variable satisfies the classical measurement error model, but it may not have repeated measurements. In addition to the surrogate variables that are available among the subjects in the calibration sample, we assume that there is an instrumental variable (IV) that is available for all study subjects. An IV is correlated with the unobserved true exposure variable and hence can be useful in the estimation of the regression coefficients. We propose a robust best linear estimator that uses all the available data, which is the most efficient among a class of consistent estimators. The proposed estimator is shown to be consistent and asymptotically normal under very weak distributional assumptions. For Poisson or linear regression, the proposed estimator is consistent even if the measurement error from the surrogate or IV is heteroscedastic. Finite-sample performance of the proposed estimator is examined and compared with other estimators via intensive simulation studies. The proposed method and other methods are applied to a bladder cancer case-control study.     

Hazard ratio estimation for biomarker-calibrated dietary exposures

Uncertainty concerning the measurement error properties of self-reported diet has important implications for the reliability of nutritional epidemiology reports. Biomarkers based on the urinary recovery of expended nutrients can provide an objective measure of short-term nutrient consumption for certain nutrients and, when applied to a subset of a study cohort, can be used to calibrate corresponding self-report nutrient consumption assessments. A nonstandard measurement error model that makes provision for systematic error and subject-specific error, along with the usual independent random error, is needed for the self-report data. Three estimation procedures for hazard ratio (Cox model) parameters are extended for application to this more complex measurement error structure. These procedures are risk set regression calibration, conditional score, and nonparametric corrected score. An estimator for the cumulative baseline hazard function is also provided. The performance of each method is assessed in a simulation study. The methods are then applied to an example from the Women's Health Initiative Dietary Modification Trial.     

Measurement error caused by spatial misalignment in environmental epidemiology

In many environmental epidemiology studies, the locations and/or times of exposure measurements and health assessments do not match. In such settings, health effects analyses often use the predictions from an exposure model as a covariate in a regression model. Such exposure predictions contain some measurement error as the predicted values do not equal the true exposures. We provide a framework for spatial measurement error modeling, showing that smoothing induces a Berkson-type measurement error with nondiagonal error structure. From this viewpoint, we review the existing approaches to estimation in a linear regression health model, including direct use of the spatial predictions and exposure simulation, and explore some modified approaches, including Bayesian models and out-of-sample regression calibration, motivated by measurement error principles. We then extend this work to the generalized linear model framework for health outcomes. Based on analytical considerations and simulation results, we compare the performance of all these approaches under several spatial models for exposure. Our comparisons underscore several important points. First, exposure simulation can perform very poorly under certain realistic scenarios. Second, the relative performance of the different methods depends on the nature of the underlying exposure surface. Third, traditional measurement error concepts can help to explain the relative practical performance of the different methods. We apply the methods to data on the association between levels of particulate matter and birth weight in the greater Boston area.     

Measurement error: Inter-and Intraobserver Variability. An Empiric Study

The intra- and inter-observer measurement error variability was studied using univariate and multivariate statistical tests. Eleven skeletal variables of four individuals each in four Primate species were measured ten times by three different researchers, using six different tools. An average measurement error of 0.52 mm. was obtained. Univariate statistics showed significant differences among reseachers. A multivariate discriminant analysis could also discriminate them. The measurement error may be either systematic or random, and depends not only on the researcher, but also on the tool used, the variable measured, and on the magnitude of the variable. The technique of Measurement Replication is proposed in order to reduce the measurement error, specially when compairing small samples or when trying to find small average differences between populations. The replication technique also reduces the standard deviation of the population sample.     

A new method for dealing with measurement error in explanatory variables of regression models

We introduce a new method, moment reconstruction, of correcting for measurement error in covariates in regression models. The central idea is similar to regression calibration in that the values of the covariates that are measured with error are replaced by "adjusted" values. In regression calibration the adjusted value is the expectation of the true value conditional on the measured value. In moment reconstruction the adjusted value is the variance-preserving empirical Bayes estimate of the true value conditional on the outcome variable. The adjusted values thereby have the same first two moments and the same covariance with the outcome variable as the unobserved "true" covariate values. We show that moment reconstruction is equivalent to regression calibration in the case of linear regression, but leads to different results for logistic regression. For case-control studies with logistic regression and covariates that are normally distributed within cases and controls, we show that the resulting estimates of the regression coefficients are consistent. In simulations we demonstrate that for logistic regression, moment reconstruction carries less bias than regression calibration, and for case-control studies is superior in mean-square error to the standard regression calibration approach. Finally, we give an example of the use of moment reconstruction in linear discriminant analysis and a nonstandard problem where we wish to adjust a classification tree for measurement error in the explanatory variables.     

Use of Two-Part Regression Calibration Model to Correct for Measurement Error in Episodically Consumed Foods in a Single-Replicate Study Design: EPIC Case Study

In epidemiologic studies, measurement error in dietary variables often attenuates association between dietary intake and disease occurrence. To adjust for the attenuation caused by error in dietary intake, regression calibration is commonly used. To apply regression calibration, unbiased reference measurements are required. Short-term reference measurements for foods that are not consumed daily contain excess zeroes that pose challenges in the calibration model. We adapted two-part regression calibration model, initially developed for multiple replicates of reference measurements per individual to a single-replicate setting. We showed how to handle excess zero reference measurements by two-step modeling approach, how to explore heteroscedasticity in the consumed amount with variance-mean graph, how to explore nonlinearity with the generalized additive modeling (GAM) and the empirical logit approaches, and how to select covariates in the calibration model. The performance of two-part calibration model was compared with the one-part counterpart. We used vegetable intake and mortality data from European Prospective Investigation on Cancer and Nutrition (EPIC) study. In the EPIC, reference measurements were taken with 24-hour recalls. For each of the three vegetable subgroups assessed separately, correcting for error with an appropriately specified two-part calibration model resulted in about three fold increase in the strength of association with all-cause mortality, as measured by the log hazard ratio. Further found is that the standard way of including covariates in the calibration model can lead to over fitting the two-part calibration model. Moreover, the extent of adjusting for error is influenced by the number and forms of covariates in the calibration model. For episodically consumed foods, we advise researchers to pay special attention to response distribution, nonlinearity, and covariate inclusion in specifying the calibration model.     

A test of homogeneity of distributions when observations are subject to measurement errors

When the observed data are contaminated with errors, the standard two-sample testing approaches that ignore measurement errors may produce misleading results, including a higher type-I error rate than the nominal level. To tackle this inconsistency, a nonparametric test is proposed for testing equality of two distributions when the observed contaminated data follow the classical additive measurement error model. The proposed test takes into account the presence of errors in the observed data, and the test statistic is defined in terms of the (deconvoluted) characteristic functions of the latent variables. Proposed method is applicable to a wide range of scenarios as no parametric restrictions are imposed either on the distribution of the underlying latent variables or on the distribution of the measurement errors. Asymptotic null distribution of the test statistic is derived, which is given by an integral of a squared Gaussian process with a complicated covariance structure. For data-based calibration of the test, a new nonparametric Bootstrap method is developed under the two-sample measurement error framework and its validity is established. Finite sample performance of the proposed test is investigated through simulation studies, and the results show superior performance of the proposed method than the standard tests that exhibit inconsistent behavior. Finally, the proposed method was applied to real data sets from the National Health and Nutrition Examination Survey. An R package MEtest is available through CRAN.     

A Semiparametric Joint Model for Longitudinal and Survival Data with Application to Hemodialysis Study

Summary .  In many longitudinal clinical studies, the level and progression rate of repeatedly measured biomarkers on each subject quantify the severity of the disease and that subject's susceptibility to progression of the disease. It is of scientific and clinical interest to relate such quantities to a later time-to-event clinical endpoint such as patient survival. This is usually done with a shared parameter model. In such models, the longitudinal biomarker data and the survival outcome of each subject are assumed to be conditionally independent given subject-level severity or susceptibility (also called frailty in statistical terms). In this article, we study the case where the conditional distribution of longitudinal data is modeled by a linear mixed-effect model, and the conditional distribution of the survival data is given by a Cox proportional hazard model. We allow unknown regression coefficients and time-dependent covariates in both models. The proposed estimators are maximizers of an exact correction to the joint log likelihood with the frailties eliminated as nuisance parameters, an idea that originated from correction of covariate measurement error in measurement error models. The corrected joint log likelihood is shown to be asymptotically concave and leads to consistent and asymptotically normal estimators. Unlike most published methods for joint modeling, the proposed estimation procedure does not rely on distributional assumptions of the frailties. The proposed method was studied in simulations and applied to a data set from the Hemodialysis Study.     

Ratio estimation with measurement error in the auxiliary variate

Summary .  With auxiliary information that is well correlated with the primary variable of interest, ratio estimation of the finite population total may be much more efficient than alternative estimators that do not make use of the auxiliary variate. The well-known properties of ratio estimators are perturbed when the auxiliary variate is measured with error. In this contribution we examine the effect of measurement error in the auxiliary variate on the design-based statistical properties of three common ratio estimators. We examine the case of systematic measurement error as well as measurement error that varies according to a fixed distribution. Aside from presenting expressions for the bias and variance of these estimators when they are contaminated with measurement error we provide numerical results based on a specific population. Under systematic measurement error, the biasing effect is asymmetric around zero, and precision may be improved or degraded depending on the magnitude of the error. Under variable measurement error, bias of the conventional ratio-of-means estimator increased slightly with increasing error dispersion, but far less than the increased bias of the conventional mean-of-ratios estimator. In similar fashion, the variance of the mean-of-ratios estimator incurs a greater loss of precision with increasing error dispersion compared with the other estimators we examine. Overall, the ratio-of-means estimator appears to be remarkably resistant to the effects of measurement error in the auxiliary variate.     

A repeated measures approach to pooled and calibrated biomarker data

Participant-level meta-analysis across multiple studies increases the sample size for pooled analyses, thereby improving precision in effect estimates and enabling subgroup analyses. For analyses involving biomarker measurements as an exposure of interest, investigators must first calibrate the data to address measurement variability arising from usage of different laboratories and/or assays. In practice, the calibration process involves reassaying a random subset of biospecimens from each study at a central laboratory and fitting models that relate the study-specific “local” and central laboratory measurements. Previous work in this area treats the calibration process from the perspective of measurement error techniques and imputes the estimated central laboratory value among individuals with only a local laboratory measurement. In this work, we propose a repeated measures method to calibrate biomarker measurements pooled from multiple studies with study-specific calibration subsets. We account for correlation between measurements made on the same person and between measurements made at the same laboratory. We demonstrate that the repeated measures approach provides valid inference, and compare it to existing calibration approaches grounded in measurement error techniques in an example describing the association between circulating vitamin D and stroke.     

A longitudinal measurement error model with a semicontinuous covariate

Covariate measurement error in regression is typically assumed to act in an additive or multiplicative manner on the true covariate value. However, such an assumption does not hold for the measurement error of sleep-disordered breathing (SDB) in the Wisconsin Sleep Cohort Study (WSCS). The true covariate is the severity of SDB, and the observed surrogate is the number of breathing pauses per unit time of sleep, which has a nonnegative semicontinuous distribution with a point mass at zero. We propose a latent variable measurement error model for the error structure in this situation and implement it in a linear mixed model. The estimation procedure is similar to regression calibration but involves a distributional assumption for the latent variable. Modeling and model-fitting strategies are explored and illustrated through an example from the WSCS.     

Semiparametric Bayesian Analysis of Nutritional Epidemiology Data in the Presence of Measurement Error

Summary : We propose a semiparametric Bayesian method for handling measurement error in nutritional epidemiological data. Our goal is to estimate nonparametrically the form of association between a disease and exposure variable while the true values of the exposure are never observed. Motivated by nutritional epidemiological data, we consider the setting where a surrogate covariate is recorded in the primary data, and a calibration data set contains information on the surrogate variable and repeated measurements of an unbiased instrumental variable of the true exposure. We develop a flexible Bayesian method where not only is the relationship between the disease and exposure variable treated semiparametrically, but also the relationship between the surrogate and the true exposure is modeled semiparametrically. The two nonparametric functions are modeled simultaneously via B‐splines. In addition, we model the distribution of the exposure variable as a Dirichlet process mixture of normal distributions, thus making its modeling essentially nonparametric and placing this work into the context of functional measurement error modeling. We apply our method to the NIH‐AARP Diet and Health Study and examine its performance in a simulation study.     

Regression Calibration in Semiparametric Accelerated Failure Time Models

Summary In large cohort studies, it often happens that some covariates are expensive to measure and hence only measured on a validation set. On the other hand, relatively cheap but error‐prone measurements of the covariates are available for all subjects. Regression calibration (RC) estimation method ( Prentice, 1982 , Biometrika 69 , 331–342) is a popular method for analyzing such data and has been applied to the Cox model by Wang et al. (1997, Biometrics 53 , 131–145) under normal measurement error and rare disease assumptions. In this article, we consider the RC estimation method for the semiparametric accelerated failure time model with covariates subject to measurement error. Asymptotic properties of the proposed method are investigated under a two‐phase sampling scheme for validation data that are selected via stratified random sampling, resulting in neither independent nor identically distributed observations. We show that the estimates converge to some well‐defined parameters. In particular, unbiased estimation is feasible under additive normal measurement error models for normal covariates and under Berkson error models. The proposed method performs well in finite‐sample simulation studies. We also apply the proposed method to a depression mortality study.     

Correcting for measurement error in fractional polynomial models using Bayesian modelling and regression calibration,with an application to alcohol and mortality

Exposure measurement error can result in a biased estimate of the association between an exposure and outcome. When the exposure–outcome relationship is linear on the appropriate scale (e.g. linear, logistic) and the measurement error is classical, that is the result of random noise, the result is attenuation of the effect. When the relationship is non‐linear, measurement error distorts the true shape of the association. Regression calibration is a commonly used method for correcting for measurement error, in which each individual's unknown true exposure in the outcome regression model is replaced by its expectation conditional on the error‐prone measure and any fully measured covariates. Regression calibration is simple to execute when the exposure is untransformed in the linear predictor of the outcome regression model, but less straightforward when non‐linear transformations of the exposure are used. We describe a method for applying regression calibration in models in which a non‐linear association is modelled by transforming the exposure using a fractional polynomial model. It is shown that taking a Bayesian estimation approach is advantageous. By use of Markov chain Monte Carlo algorithms, one can sample from the distribution of the true exposure for each individual. Transformations of the sampled values can then be performed directly and used to find the expectation of the transformed exposure required for regression calibration. A simulation study shows that the proposed approach performs well. We apply the method to investigate the relationship between usual alcohol intake and subsequent all‐cause mortality using an error model that adjusts for the episodic nature of alcohol consumption.     

Bias analysis and the simulation‐extrapolation method for survival data with covariate measurement error under parametric proportional odds models

It has been well known that ignoring measurement error may result in substantially biased estimates in many contexts including linear and nonlinear regressions. For survival data with measurement error in covariates, there has been extensive discussion in the literature with the focus on proportional hazards (PH) models. Recently, research interest has extended to accelerated failure time (AFT) and additive hazards (AH) models. However, the impact of measurement error on other models, such as the proportional odds model, has received relatively little attention, although these models are important alternatives when PH, AFT, or AH models are not appropriate to fit data. In this paper, we investigate this important problem and study the bias induced by the naive approach of ignoring covariate measurement error. To adjust for the induced bias, we describe the simulation‐extrapolation method. The proposed method enjoys a number of appealing features. Its implementation is straightforward and can be accomplished with minor modifications of existing software. More importantly, the proposed method does not require modeling the covariate process, which is quite attractive in practice. As the precise values of error‐prone covariates are often not observable, any modeling assumption on such covariates has the risk of model misspecification, hence yielding invalid inferences if this happens. The proposed method is carefully assessed both theoretically and empirically. Theoretically, we establish the asymptotic normality for resulting estimators. Numerically, simulation studies are carried out to evaluate the performance of the estimators as well as the impact of ignoring measurement error, along with an application to a data set arising from the Busselton Health Study. Sensitivity of the proposed method to misspecification of the error model is studied as well.     

A simulation-based marginal method for longitudinal data with dropout and mismeasured covariates

Longitudinal data often contain missing observations and error-prone covariates. Extensive attention has been directed to analysis methods to adjust for the bias induced by missing observations. There is relatively little work on investigating the effects of covariate measurement error on estimation of the response parameters, especially on simultaneously accounting for the biases induced by both missing values and mismeasured covariates. It is not clear what the impact of ignoring measurement error is when analyzing longitudinal data with both missing observations and error-prone covariates. In this article, we study the effects of covariate measurement error on estimation of the response parameters for longitudinal studies. We develop an inference method that adjusts for the biases induced by measurement error as well as by missingness. The proposed method does not require the full specification of the distribution of the response vector but only requires modeling its mean and variance structures. Furthermore, the proposed method employs the so-called functional modeling strategy to handle the covariate process, with the distribution of covariates left unspecified. These features, plus the simplicity of implementation, make the proposed method very attractive. In this paper, we establish the asymptotic properties for the resulting estimators. With the proposed method, we conduct sensitivity analyses on a cohort data set arising from the Framingham Heart Study. Simulation studies are carried out to evaluate the impact of ignoring covariate measurement error and to assess the performance of the proposed method.     

Maximally selected chi-square statistics for ordinal variables

The association between a binary variable Y and a variable X having an at least ordinal measurement scale might be examined by selecting a cutpoint in the range of X and then performing an association test for the obtained 2 x 2 contingency table using the chi-square statistic. The distribution of the maximally selected chi-square statistic (i.e. the maximal chi-square statistic over all possible cutpoints) under the null-hypothesis of no association between X and Y is different from the known chi-square distribution. In the last decades, this topic has been extensively studied for continuous X variables, but not for non-continuous variables of at least ordinal measurement scale (which include e.g. classical ordinal or discretized continuous variables). In this paper, we suggest an exact method to determine the finite-sample distribution of maximally selected chi-square statistics in this context. This novel approach can be seen as a method to measure the association between a binary variable and variables having an at least ordinal scale of different types (ordinal, discretized continuous, etc). As an illustration, this method is applied to a new data set describing pregnancy and birth for 811 babies.     

Approximate maximum likelihood estimation for logistic regression with covariate measurement error

In nutritional epidemiology, dietary intake assessed with a food frequency questionnaire is prone to measurement error. Ignoring the measurement error in covariates causes estimates to be biased and leads to a loss of power. In this paper, we consider an additive error model according to the characteristics of the European Prospective Investigation into Cancer and Nutrition (EPIC)‐InterAct Study data, and derive an approximate maximum likelihood estimation (AMLE) for covariates with measurement error under logistic regression. This method can be regarded as an adjusted version of regression calibration and can provide an approximate consistent estimator. Asymptotic normality of this estimator is established under regularity conditions, and simulation studies are conducted to empirically examine the finite sample performance of the proposed method. We apply AMLE to deal with measurement errors in some interested nutrients of the EPIC‐InterAct Study under a sensitivity analysis framework.