The 2-sample problem for failure rates depending on a continuous mark: an application to vaccine efficacy

The efficacy of an HIV vaccine to prevent infection is likely to depend on the genetic variation of the exposing virus. This paper addresses the problem of using data on the HIV sequences that infect vaccine efficacy trial participants to (1) test for vaccine efficacy more powerfully than procedures that ignore the sequence data and (2) evaluate the dependence of vaccine efficacy on the divergence of infecting HIV strains from the HIV strain that is contained in the vaccine. Because hundreds of amino acid sites in each HIV genome are sequenced, it is natural to treat the genetic divergence as a continuous mark variable that accompanies each failure (infection) time. Problems (1) and (2) can then be approached by testing whether the ratio of the mark-specific hazard functions for the vaccine and placebo groups is unity or independent of the mark. We develop nonparametric and semiparametric tests for these null hypotheses and nonparametric techniques for estimating the mark-specific relative risks. The asymptotic properties of the procedures are established. In addition, the methods are studied in simulations and are applied to HIV genetic sequence data collected in the first HIV vaccine efficacy trial.     

Hypothesis tests for stratified mark‐specific proportional hazards models with missing covariates,with application to HIV vaccine efficacy trials

This article develops hypothesis testing procedures for the stratified mark‐specific proportional hazards model with missing covariates where the baseline functions may vary with strata. The mark‐specific proportional hazards model has been studied to evaluate mark‐specific relative risks where the mark is the genetic distance of an infecting HIV sequence to an HIV sequence represented inside the vaccine. This research is motivated by analyzing the RV144 phase 3 HIV vaccine efficacy trial, to understand associations of immune response biomarkers on the mark‐specific hazard of HIV infection, where the biomarkers are sampled via a two‐phase sampling nested case‐control design. We test whether the mark‐specific relative risks are unity and how they change with the mark. The developed procedures enable assessment of whether risk of HIV infection with HIV variants close or far from the vaccine sequence are modified by immune responses induced by the HIV vaccine; this question is interesting because vaccine protection occurs through immune responses directed at specific HIV sequences. The test statistics are constructed based on augmented inverse probability weighted complete‐case estimators. The asymptotic properties and finite‐sample performances of the testing procedures are investigated, demonstrating double‐robustness and effectiveness of the predictive auxiliaries to recover efficiency. The finite‐sample performance of the proposed tests are examined through a comprehensive simulation study. The methods are applied to the RV144 trial.     

Estimation of Stratified Mark-Specific Proportional Hazards Models Under Two-Phase Sampling with Application to HIV Vaccine Efficacy Trials

An objective of preventive HIV vaccine efficacy trials is to understand how vaccine-induced immune responses to specific protein sequences of HIV-1 associate with subsequent infection with specific sequences of HIV, where the immune response biomarkers are measured in vaccine recipients via a two-phase sampling design. Motivated by this objective, we investigate the stratified mark-specific proportional hazards model under two-phase biomarker sampling, where the mark is the genetic distance of an infecting HIV-1 sequence to an HIV-1 sequence represented inside the vaccine. Estimation and inference procedures based on inverse probability weighting of complete-cases and on augmented inverse probability weighting of complete-cases are developed. Asymptotic properties of the estimators are derived and their finite-sample performances are examined in simulation studies. The methods are shown to have satisfactory performance and are applied to the RV144 vaccine trial to assess whether immune response correlates of HIV-1 infection are stronger for HIV-1 infecting sequences similar to the vaccine than for sequences distant from the vaccine.     

Nonparametric maximum likelihood estimation for competing risks survival data subject to interval censoring and truncation

We derive the nonparametric maximum likelihood estimate (NPMLE) of the cumulative incidence functions for competing risks survival data subject to interval censoring and truncation. Since the cumulative incidence function NPMLEs give rise to an estimate of the survival distribution which can be undefined over a potentially larger set of regions than the NPMLE of the survival function obtained ignoring failure type, we consider an alternative pseudolikelihood estimator. The methods are then applied to data from a cohort of injecting drug users in Thailand susceptible to infection from HIV-1 subtypes B and E.     

Estimation in the cox proportional hazards model with left-truncated and interval-censored data

We show that the nonparametric maximum likelihood estimate (NPMLE) of the regression coefficient from the joint likelihood (of the regression coefficient and the baseline survival) works well for the Cox proportional hazards model with left-truncated and interval-censored data, but the NPMLE may underestimate the baseline survival. Two alternatives are also considered: first, the marginal likelihood approach by extending Satten (1996, Biometrika 83, 355-370) to truncated data, where the baseline distribution is eliminated as a nuisance parameter; and second, the monotone maximum likelihood estimate that maximizes the joint likelihood by assuming that the baseline distribution has a nondecreasing hazard function, which was originally proposed to overcome the underestimation of the survival from the NPMLE for left-truncated data without covariates (Tsai, 1988, Biometrika 75, 319-324). The bootstrap is proposed to draw inference. Simulations were conducted to assess their performance. The methods are applied to the Massachusetts Health Care Panel Study data set to compare the probabilities of losing functional independence for male and female seniors.     

Joint Models of Longitudinal Data and Recurrent Events with Informative Terminal Event

This article presents semiparametric joint models to analyze longitudinal data with recurrent events (e.g. multiple tumors, repeated hospital admissions) and a terminal event such as death. A broad class of transformation models for the cumulative intensity of the recurrent events and the cumulative hazard of the terminal event is considered, which includes the proportional hazards model and the proportional odds model as special cases. We propose to estimate all the parameters using the nonparametric maximum likelihood estimators (NPMLE). We provide the simple and efficient EM algorithms to implement the proposed inference procedure. Asymptotic properties of the estimators are shown to be asymptotically normal and semiparametrically efficient. Finally, we evaluate the performance of the method through extensive simulation studies and a real-data application.     

Semiparametric additive time-varying coefficients model for longitudinal data with censored time origin

Statistical analysis of longitudinal data often involves modeling treatment effects on clinically relevant longitudinal biomarkers since an initial event (the time origin). In some studies including preventive HIV vaccine efficacy trials, some participants have biomarkers measured starting at the time origin, whereas others have biomarkers measured starting later with the time origin unknown. The semiparametric additive time-varying coefficient model is investigated where the effects of some covariates vary nonparametrically with time while the effects of others remain constant. Weighted profile least squares estimators coupled with kernel smoothing are developed. The method uses the expectation maximization approach to deal with the censored time origin. The Kaplan–Meier estimator and other failure time regression models such as the Cox model can be utilized to estimate the distribution and the conditional distribution of left censored event time related to the censored time origin. Asymptotic properties of the parametric and nonparametric estimators and consistent asymptotic variance estimators are derived. A two-stage estimation procedure for choosing weight is proposed to improve estimation efficiency. Numerical simulations are conducted to examine finite sample properties of the proposed estimators. The simulation results show that the theory and methods work well. The efficiency gain of the two-stage estimation procedure depends on the distribution of the longitudinal error processes. The method is applied to analyze data from the Merck 023/HVTN 502 Step HIV vaccine study.     

Weighted Likelihood Method for Grouped Survival Data in Case–Cohort Studies with Application to HIV Vaccine Trials

Summary Grouped failure time data arise often in HIV studies. In a recent preventive HIV vaccine efficacy trial, immune responses generated by the vaccine were measured from a case–cohort sample of vaccine recipients, who were subsequently evaluated for the study endpoint of HIV infection at prespecified follow‐up visits. Gilbert et al. (2005, Journal of Infectious Diseases 191 , 666–677) and Forthal et al. (2007, Journal of Immunology 178, 6596–6603) analyzed the association between the immune responses and HIV incidence with a Cox proportional hazards model, treating the HIV infection diagnosis time as a right‐censored random variable. The data, however, are of the form of grouped failure time data with case–cohort covariate sampling, and we propose an inverse selection probability‐weighted likelihood method for fitting the Cox model to these data. The method allows covariates to be time dependent, and uses multiple imputation to accommodate covariate data that are missing at random. We establish asymptotic properties of the proposed estimators, and present simulation results showing their good finite sample performance. We apply the method to the HIV vaccine trial data, showing that higher antibody levels are associated with a lower hazard of HIV infection.     

A nonparametric estimator of species overlap

For two communities, species overlap has been defined by Smith, Solow, and Preston (1996, Biometrics 52, 1472-1477) as the probability that a randomly selected species is present in both communities given that it is present in at least one community. Species overlap can thus be used to describe the similarity of two communities. In contrast with the parametric estimator of Smith et al., we propose a nonparametric maximum likelihood estimator (NPMLE). We prove that the NPMLE is consistent and asymptotically normally distributed and show that computation of the NPMLE and its standard error is straightforward. We also compare the NPMLE and the estimator of Smith et al. for a variety of situations.     

3-Carboxy-cis,cis-muconate lactonizing enzyme from Neurospora crassa: an alternate cycloisomerase motif.

3-Carboxy-cis,cis-muconate lactonizing enzyme (CMLE; EC 5.5.1.5) from Neurospora crassa catalyzes the reversible gamma-lactonization of 3-carboxy-cis,cis-muconate by a syn-1,2 addition-elimination reaction. The stereochemical and regiochemical course of the reaction is (i) opposite that of CMLE from Pseudomonas putida (EC 5.5.1.2) and (ii) identical to that of cis,cis-muconate lactonizing enzyme (MLE; EC 5.5.1.1) from P. putida. In order to determine the mechanistic and evolutionary relationships between N. crassa CMLE and the procaryotic cycloisomerases, we have purified CMLE from N. crassa to homogeneity and determined its nucleotide sequence from a cDNA clone isolated from a p-hydroxybenzoate-induced N. crassa cDNA library. The deduced amino acid sequence predicts a protein of 41.2 kDa (365 residues) which does not exhibit sequence similarity with any of the bacterial cycloisomerases. The cDNA encoding N. crassa CMLE was expressed in Escherichia coli, and the purified recombinant protein exhibits physical and kinetic properties equivalent to those found for the isolated N. crassa enzyme. We also report that N. crassa CMLE possesses substantially reduced yet significant levels of MLE activity with cis,cis-muconate and, furthermore, does not appear to be dependent on divalent metals for activity. These data suggest that the N. crassa CMLE may represent a novel eucaryotic motif in the cycloisomerase enzyme family.     

Nonparametric estimation of stage occupation probabilities in a multistage model with current status data

Multistage models are used to describe individuals (or experimental units) moving through a succession of "stages" corresponding to distinct states (e.g., healthy, diseased, diseased with complications, dead). The resulting data can be considered to be a form of multivariate survival data containing information about the transition times and the stages occupied. Traditional survival analysis is the simplest example of a multistage model, where individuals begin in an initial stage (say, alive) and move irreversibly to a second stage (death). In this article, we consider general multistage models with a directed tree structure (progressive models) in which individuals traverse through stages in a possibly non-Markovian manner. We construct nonparametric estimators of stage occupation probabilities and marginal cumulative transition hazards. Empirical calculations of these quantities are not possible due to the lack of complete data. We consider current status information which represents a more severe form of censoring than the commonly used right censoring. Asymptotic validity of our estimators can be justified using consistency results for nonparametric regression estimators. Finite-sample behavior of our estimators is studied by simulation, in which we show that our estimators based on these limited data compare well with those based on complete data. We also apply our method to a real-life data set arising from a cardiovascular diseases study in Taiwan.     

Genome scanning tests for comparing amino acid sequences between groups

Summary .   Consider a placebo-controlled preventive HIV vaccine efficacy trial. An HIV amino acid sequence is measured from each volunteer who acquires HIV, and these sequences are aligned together with the reference HIV sequence represented in the vaccine. We develop genome scanning methods to identify positions at which the amino acids in infected vaccine recipient sequences either (A) are more divergent from the reference amino acid than the amino acids in infected placebo recipient sequences or (B) have a different frequency distribution than the placebo sequences, irrespective of a reference amino acid. We consider t -test-type statistics for problem A and Euclidean, Mahalanobis, and Kullback–Leibler-type statistics for problem B. The test statistics incorporate weights to reflect biological information contained in different amino acid positions and mismatches. Position-specific p -values are obtained by approximating the null distribution of the statistics either by a permutation procedure or by a nonparametric estimation. A permutation method is used to estimate a cut-off p -value to control the per comparison error rate at a prespecified level. The methods are examined in simulations and are applied to two HIV examples. The methods for problem B address the general problem of comparing discrete frequency distributions between groups in a high-dimensional data setting.     

On restricted mean time in favor of treatment

The restricted mean time in favor (RMT-IF) of treatment is a nonparametric effect size for complex life history data. It is defined as the net average time the treated spend in a more favorable state than the untreated over a prespecified time window. It generalizes the familiar restricted mean survival time (RMST) from the two-state life–death model to account for intermediate stages in disease progression. The overall estimand can be additively decomposed into stage-wise effects, with the standard RMST as a component. Alternate expressions of the overall and stage-wise estimands as integrals of the marginal survival functions for a sequence of landmark transitioning events allow them to be easily estimated by plug-in Kaplan–Meier estimators. The dynamic profile of the estimated treatment effects as a function of follow-up time can be visualized using a multilayer, cone-shaped “bouquet plot.” Simulation studies under realistic settings show that the RMT-IF meaningfully and accurately quantifies the treatment effect and outperforms traditional tests on time to the first event in statistical efficiency thanks to its fuller utilization of patient data. The new methods are illustrated on a colon cancer trial with relapse and death as outcomes and a cardiovascular trial with recurrent hospitalizations and death as outcomes. The R-package rmt implements the proposed methodology and is publicly available from the Comprehensive R Archive Network (CRAN).     

Time-dependent ROC curves for censored survival data and a diagnostic marker

ROC curves are a popular method for displaying sensitivity and specificity of a continuous diagnostic marker, X, for a binary disease variable, D. However, many disease outcomes are time dependent, D(t), and ROC curves that vary as a function of time may be more appropriate. A common example of a time-dependent variable is vital status, where D(t) = 1 if a patient has died prior to time t and zero otherwise. We propose summarizing the discrimination potential of a marker X, measured at baseline (t = 0), by calculating ROC curves for cumulative disease or death incidence by time t, which we denote as ROC(t). A typical complexity with survival data is that observations may be censored. Two ROC curve estimators are proposed that can accommodate censored data. A simple estimator is based on using the Kaplan-Meier estimator for each possible subset X > c. However, this estimator does not guarantee the necessary condition that sensitivity and specificity are monotone in X. An alternative estimator that does guarantee monotonicity is based on a nearest neighbor estimator for the bivariate distribution function of (X, T), where T represents survival time (Akritas, M. J., 1994, Annals of Statistics 22, 1299-1327). We present an example where ROC(t) is used to compare a standard and a modified flow cytometry measurement for predicting survival after detection of breast cancer and an example where the ROC(t) curve displays the impact of modifying eligibility criteria for sample size and power in HIV prevention trials.     

3-Carboxy-cis,cis-muconate lactonizing enzyme from Pseudomonas putida is homologous to the class II fumarase family: a new reaction in the evolution of a mechanistic motif.

The gene (pcaB) for 3-carboxymuconate lactonizing enzyme (CMLE; 3-carboxymuconate cycloisomerase; EC 5.5.1.2) from Pseudomonas putida has been cloned into pMG27NS, a temperature-sensitive expression vector, and expressed in Escherichia coli N4830. The specific activity and kinetic parameters of the recombinant CMLE were comparable to those previously reported. A comparison of the deduced amino acid sequence of CMLE with sequences available in the PIR and Genbank databases revealed that CMLE has highly significant sequence homology to the class II fumarase family, particularly to adenylosuccinate lyase from Bacillus subtilis. CMLE has no significant homology to muconate lactonizing enzyme (MLE) from P. putida, its sister enzyme in the beta-ketoadipate pathway. These findings fully corroborate a prediction made by us on the basis of mechanistic and stereochemical analyses of CMLE and MLE [Chari, R. V. J., Whitman, C. P., Kozarich, J. W., Ngai, K.-L., & Ornston, L. N. (1987) J. Am. Chem. Soc. 109, 5514-5519] and suggest that CMLE and MLE were recruited into this specialized pathway from two different enzyme families.     

Nonparametric inference for competing risks current status data with continuous, discrete or grouped observation times

New methods and theory have recently been developed to nonparametrically estimate cumulative incidence functions for competing risks survival data subject to current status censoring. In particular, the limiting distribution of the nonparametric maximum likelihood estimator and a simplified naive estimator have been established under certain smoothness conditions. In this paper, we establish the large-sample behaviour of these estimators in two additional models, namely when the observation time distribution has discrete support and when the observation times are grouped. These asymptotic results are applied to the construction of confidence intervals in the three different models. The methods are illustrated on two datasets regarding the cumulative incidence of different types of menopause from a cross-sectional sample of women in the United States and subtype-specific HIV infection from a sero-prevalence study in injecting drug users in Thailand.     

Approximate nonparametric corrected-score method for joint modeling of survival and longitudinal data measured with error

We consider the problem of jointly modeling survival time and longitudinal data subject to measurement error. The survival times are modeled through the proportional hazards model and a random effects model is assumed for the longitudinal covariate process. Under this framework, we propose an approximate nonparametric corrected-score estimator for the parameter, which describes the association between the time-to-event and the longitudinal covariate. The term nonparametric refers to the fact that assumptions regarding the distribution of the random effects and that of the measurement error are unnecessary. The finite sample size performance of the approximate nonparametric corrected-score estimator is examined through simulation studies and its asymptotic properties are also developed. Furthermore, the proposed estimator and some existing estimators are applied to real data from an AIDS clinical trial.     

Nonparametric estimation of a Markov 'illness-death' process from interval-censored observations, with application to diabetes survival data

The nonparametric estimation of the cumulative transition intensityfunctions in a threestate time-nonhomogeneous Markov processwith irreversible transitions, an ‘illness-death’model, is considered when times of the intermediate transition,e.g. onset of a disease, are interval-censored. The times of‘death’ are assumed to be known exactly or to beright-censored. In addition the observed process may be left-truncated.Data of this type arise when the process is sampled periodically.For example, when the patients are monitored through periodicexaminations the observations on times of change in their diseasestatus will be interval-censored. Under the sampling schemeconsidered here the Nelson–Aalen estimator (Aalen, 1978)for a cumulative transition intensity is not applicable. Inthe proposed method the maximum likelihood estimators of someof the transition intensities are derived from the estimatorsof the corresponding subdistribution functions. The maximumlikelihood estimators are shown to have a self-consistency property.The self-consistency algorithm is developed for the computationof the estimators. This approach generalises the results fromTurnbull (1976) and Frydman (1992). The methods are illustratedwith diabetes survival data.     

Analysis of doubly-censored survival data, with application to AIDS

This paper proposes nonparametric and weakly structured parametric methods for analyzing survival data in which both the time origin and the failure event can be right- or interval-censored. Such data arise in clinical investigations of the human immunodeficiency virus (HIV) when the infection and clinical status of patients are observed only at several time points. The proposed methods generalize the self-consistency algorithm proposed by Turnbull (1976, Journal of the Royal Statistical Society, Series B 38, 290-295) for singly-censored univariate data, and are illustrated with the results from a study of hemophiliacs who were infected with HIV by contaminated blood factor.     

Quantile Inference with Multivariate Failure Time Data

Quantiles, especially the medians, of survival times are often used as summary statistics to compare the survival experiences between different groups. Quantiles are robust against outliers and preferred over the mean. Multivariate failure time data often arise in biomedical research. For example, in clinical trials, each patient in the study may experience multiple events which may be of the same type or distinct types, while in family studies of genetic diseases or litter matched mice studies, failure times for subjects in the same cluster may be correlated. In this article, we propose nonparametric procedures for the estimation of quantiles with multivariate failure time data. We show that the proposed estimators asymptotically follow a multivariate normal distribution. The asymptotic variance‐covariance matrix of the estimated quantiles is estimated based on the kernel smoothing and bootstrap techniques. Simulation results show that the proposed estimators perform well in finite samples. The methods are illustrated with the burn‐wound infection data and the Diabetic Retinopathy Study (DRS) data.