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1.
    
Random survival forests (RSF) can be applied to many time-to-event research questions and are particularly useful in situations where the relationship between the independent variables and the event of interest is rather complex. However, in many clinical settings, the occurrence of the event of interest is affected by competing events, which means that a patient can experience an outcome other than the event of interest. Neglecting the competing event (i.e., regarding competing events as censoring) will typically result in biased estimates of the cumulative incidence function (CIF). A popular approach for competing events is Fine and Gray's subdistribution hazard model, which directly estimates the CIF by fitting a single-event model defined on a subdistribution timescale. Here, we integrate concepts from the subdistribution hazard modeling approach into the RSF. We develop several imputation strategies that use weights as in a discrete-time subdistribution hazard model to impute censoring times in cases where a competing event is observed. Our simulations show that the CIF is well estimated if the imputation already takes place outside the forest on the overall dataset. Especially in settings with a low rate of the event of interest or a high censoring rate, competing events must not be neglected, that is, treated as censoring. When applied to a real-world epidemiological dataset on chronic kidney disease, the imputation approach resulted in highly plausible predictor–response relationships and CIF estimates of renal events.  相似文献   

2.
    
In clinical study reports (CSRs), adverse events (AEs) are commonly summarized using the incidence proportion (IP). IPs can be calculated for all types of AEs and are often interpreted as the probability that a treated patient experiences specific AEs. Exposure time can be taken into account with time-to-event methods. Using one minus Kaplan–Meier (1-KM) is known to overestimate the AE probability in the presence of competing events (CEs). The use of a nonparametric estimator of the cumulative incidence function (CIF) has therefore been advocated as more appropriate. In this paper, we compare different methods to estimate the probability of one selected AE. In particular, we investigate whether the proposed methods provide a reasonable estimate of the AE probability at an interim analysis (IA). The characteristics of the methods in the presence of a CE are illustrated using data from a breast cancer study and we quantify the potential bias in a simulation study. At the final analysis performed for the CSR, 1-KM systematically overestimates and in most cases IP slightly underestimates the given AE probability. CIF has the lowest bias in most simulation scenarios. All methods might lead to biased estimates at the IA except for AEs with early onset. The magnitude of the bias varies with the time-to-AE and/or CE occurrence, the selection of event-specific hazards and the amount of censoring. In general, reporting AE probabilities for prespecified fixed time points is recommended.  相似文献   

3.
    
A competing risk approach was used to evaluate the influence of several factors on culling risk for 587 Duroc sows. Three different analyses were performed according to whether sow failure was due to death during productive life (DE) or to one of two causes for voluntary culling: low productivity (LP) and low fertility (LF). Sow survival was analyzed by the Cox model. Year at first farrowing (batch effect) significantly affected sow survival in all three analyses (P < 0.05 for DE and P < 0.001 for LP and LF) whereas farm of origin accounted for relevant variation in the LP and LF analyses. LP culling increased with backfat thickness of more than 19 mm at the end of the growth period (P < 0.05), bad teat condition (P < 0.05) and reduced piglets born alive (P < 0.001). For the LF competing risk analysis, culling increased with age at first farrowing (P < 0.1). Special emphasis was placed on the influence of leg and teat conformation on sow survivability, although they did not affect sow failure due to DE (P > 0.1). The overall leg-conformation score significantly influenced sow longevity in LP (P < 0.001) and LF competing risk analyses (P < 0.001), showing a higher hazard ratio (HR) for poorly conformed sows (1.013 and 4.366, respectively) than for well-conformed sows (0.342 and 0.246, respectively). Survival decreased with the presence of abnormal hoof growth in LP and LF analyses (HR = 3.372 and 6.002, respectively; P < 0.001) and bumps or injuries to legs (HR = 4.172 and 5.839, respectively; P < 0.01). Plantigradism reduced sow survival in the LP analysis (P < 0.05), while sickle-hooked leg (P < 0.05) impaired sow survival in the fertility-specific analysis. Estimates of heritability for longevity related to LP culling ranged from 0.008 to 0.024 depending on the estimation procedure, whereas heritability values increased to between 0.017 and 0.083 in LF analysis. These analyses highlighted substantial discrepancies in the sources of variation and genetic background of sow longevity depending on the cause of failure. The estimated heritabilities suggested that direct genetic improvement for sow longevity seemed feasible, although only a small genetic progress was expected.  相似文献   

4.
    
When modeling competing risks (CR) survival data, several techniques have been proposed in both the statistical and machine learning literature. State-of-the-art methods have extended classical approaches with more flexible assumptions that can improve predictive performance, allow high-dimensional data and missing values, among others. Despite this, modern approaches have not been widely employed in applied settings. This article aims to aid the uptake of such methods by providing a condensed compendium of CR survival methods with a unified notation and interpretation across approaches. We highlight available software and, when possible, demonstrate their usage via reproducible R vignettes. Moreover, we discuss two major concerns that can affect benchmark studies in this context: the choice of performance metrics and reproducibility.  相似文献   

5.
    
In this paper, we introduce a new model for recurrent event data characterized by a baseline rate function fully parametric, which is based on the exponential‐Poisson distribution. The model arises from a latent competing risk scenario, in the sense that there is no information about which cause was responsible for the event occurrence. Then, the time of each recurrence is given by the minimum lifetime value among all latent causes. The new model has a particular case, which is the classical homogeneous Poisson process. The properties of the proposed model are discussed, including its hazard rate function, survival function, and ordinary moments. The inferential procedure is based on the maximum likelihood approach. We consider an important issue of model selection between the proposed model and its particular case by the likelihood ratio test and score test. Goodness of fit of the recurrent event models is assessed using Cox‐Snell residuals. A simulation study evaluates the performance of the estimation procedure in the presence of a small and moderate sample sizes. Applications on two real data sets are provided to illustrate the proposed methodology. One of them, first analyzed by our team of researchers, considers the data concerning the recurrence of malaria, which is an infectious disease caused by a protozoan parasite that infects red blood cells.  相似文献   

6.
In the present paper, a variation of the methode of translation is discussed to generate bivariate or multivariate survival distributions starting a given bivariate or multivariate distribution which is not necessarily a life distribution. The new distribution has been called the dual of the given distribution. The duals of several bivariate and multivariate famílies of distributions are obtained, such as FRECHET'S , FARLIE -GUMBEL -MORGENSTERN'S , MARDIA'S and PLACKETT'S , among others. A necessary and sufficient condition is given for a bivariate distribution to be its own dual. Thus the present paper generates several survival distributions in addition to what are already available in the literature. These have important applications in competing risk theory or reliability of engineering systems.  相似文献   

7.
    
The survival rate of mosquitoes is an important topic that affects many aspects of decision‐making in mosquito management. This study aims to estimate the variability in the survival rate of Ae. aegypti, and climate factors that are related to such variability. It is generally assumed that the daily probability of mosquito survival is independent of natural environment conditions and age. To test this assumption, a three‐year fieldwork (2005–2007) and experimental study was conducted at Fortaleza‐CE in Brazil with the aim of estimating daily survival rates of the dengue vector Aedes aegypti under natural conditions in an urban city. Survival rates of mosquitoes may be age‐dependent and statistical analysis is a sensitive approach for comparing patterns of mosquito survival. We studied whether weather conditions occurring on a particular day influence the mortality observed on that particular day. We therefore focused on the impact of daily meteorological fluctuations around a given climate average, rather than on the influence of climate itself. With regard to survival time, multivariate analyses using the stepwise logistic regression model, adjusted for daily temperature, relative humidity, and saturated vapor pressure deficit (SVPD), suggest that age, the seasonal factor, and the SVPD were the most dependent mortality factors. Similar results were obtained using the Cox proportional hazard model, which explores the relationships between the survival and explanatory variables.  相似文献   

8.
Wang, et al.'s estimator for causal hazard ratios for endogenous treatments makes an important addition to a researcher's toolkit for analyzing censored duration outcomes. Their method complements existing methods in the semiparametric treatment effects literature and suggests useful avenues for future research.  相似文献   

9.
The Fine–Gray proportional subdistribution hazards model has been puzzling many people since its introduction. The main reason for the uneasy feeling is that the approach considers individuals still at risk for an event of cause 1 after they fell victim to the competing risk of cause 2. The subdistribution hazard and the extended risk sets, where subjects who failed of the competing risk remain in the risk set, are generally perceived as unnatural . One could say it is somewhat of a riddle why the Fine–Gray approach yields valid inference. To take away these uneasy feelings, we explore the link between the Fine–Gray and cause-specific approaches in more detail. We introduce the reduction factor as representing the proportion of subjects in the Fine–Gray risk set that has not yet experienced a competing event. In the presence of covariates, the dependence of the reduction factor on a covariate gives information on how the effect of the covariate on the cause-specific hazard and the subdistribution hazard relate. We discuss estimation and modeling of the reduction factor, and show how they can be used in various ways to estimate cumulative incidences, given the covariates. Methods are illustrated on data of the European Society for Blood and Marrow Transplantation.  相似文献   

10.
    
A cause-specific cumulative incidence function (CIF) is the probability of failure from a specific cause as a function of time. In randomized trials, a difference of cause-specific CIFs (treatment minus control) represents a treatment effect. Cause-specific CIF in each intervention arm can be estimated based on the usual non-parametric Aalen–Johansen estimator which generalizes the Kaplan–Meier estimator of CIF in the presence of competing risks. Under random censoring, asymptotically valid Wald-type confidence intervals (CIs) for a difference of cause-specific CIFs at a specific time point can be constructed using one of the published variance estimators. Unfortunately, these intervals can suffer from substantial under-coverage when the outcome of interest is a rare event, as may be the case for example in the analysis of uncommon adverse events. We propose two new approximate interval estimators for a difference of cause-specific CIFs estimated in the presence of competing risks and random censoring. Theoretical analysis and simulations indicate that the new interval estimators are superior to the Wald CIs in the sense of avoiding substantial under-coverage with rare events, while being equivalent to the Wald CIs asymptotically. In the absence of censoring, one of the two proposed interval estimators reduces to the well-known Agresti–Caffo CI for a difference of two binomial parameters. The new methods can be easily implemented with any software package producing point and variance estimates for the Aalen–Johansen estimator, as illustrated in a real data example.  相似文献   

11.
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This article develops omnibus tests for comparing cause-specific hazard rates and cumulative incidence functions at specified covariate levels. Confidence bands for the difference and the ratio of two conditional cumulative incidence functions are also constructed. The omnibus test is formulated in terms of a test process given by a weighted difference of estimates of cumulative cause-specific hazard rates under Cox proportional hazards models. A simulation procedure is devised for sampling from the null distribution of the test process, leading to graphical and numerical technques for detecting significant differences in the risks. The approach is applied to a cohort study of type-specific HIV infection rates.  相似文献   

13.
    
Growing evidence has revealed that long noncoding RNAs (lncRNAs) have an important impact on tumorigenesis and tumor progression via a mechanism involving competing endogenous RNAs (ceRNAs). However, their use in predicting the survival of a patient with hepatocellular carcinoma (HCC) remains unclear. The aim of this study was to develop a novel lncRNA expression–based risk score system to accurately predict the survival of patients with HCC. In our study, using expression profiles downloaded from The Cancer Genome Atlas database, the differentially expressed messenger RNAs (mRNAs), lncRNAs, and microRNAs (miRNAs) were explored in patients with HCC and normal liver tissues, and then a ceRNA network constructed. A risk score system was established between lncRNA expression of the ceRNA network and overall survival (OS) or recurrence-free survival (RFS); it was further analyzed for associations with the clinical features of patients with HCC. In HCC, 473 differentially expressed lncRNAs, 63 differentially expressed miRNAs, and 1417 differentially expressed mRNAs were detected. The ceRNA network comprised 41 lncRNA nodes, 12 miRNA nodes, 24 mRNA nodes, and 172 edges. The lncRNA expression–based risk score system for OS was constructed based on six lncRNAs (MYLK-AS1, AL359878.1, PART1, TSPEAR-AS1, C10orf91, and LINC00501), while the risk score system for RFS was based on four lncRNAs (WARS2-IT1, AL359878.1, AL357060.1, and PART1). Univariate and multivariate Cox analyses showed the risk score systems for OS or RFS were significant independent factors adjusted for clinical factors. Receiver operating characteristic curve analysis showed the area under the curve for the risk score system was 0.704 for OS, and 0.71 for RFS. Our result revealed a lncRNA expression–based risk score system for OS or RFS can effectively predict the survival of patients with HCC and aid in good clinical decision-making.  相似文献   

14.
We observed patch-use behavior by two gerbil species in a fieldsetting and investigated how aggression and intrinsic decision-makinginteract to influence patch residence times. Results were interpretedby using a competing risk analysis model, which uniquely enabledus to estimate the intrinsic patch-leaving decisions independentlyof external interruptions of foraging bouts by aggression. Theexperiment was conducted in two 1-ha field enclosures completelysurrounded by rodent-proof fences and included allopatric (onlyGerbillus andersoni allenbyi) and sympatric (G. a. allenbyiand G. pyramidum) treatments. We predicted that increased foodpatch quality (i.e., habitat quality) should decrease intrinsicpatch-leaving rates and increase rates of aggressive interactionsinvolving the forager feeding in the patch (i.e., the occupantindividual). We also anticipated that increasing populationdensity should result in an increase in the rate of aggressiveinteractions involving the occupant individual. Our resultssupported the first two predictions, indicating a trade-offbetween foraging and aggression. However, the third predictionwas realized only for G. a. allenbyi in allopatry. Furthermore,in allopatry, occupant G. a. allenbyi individuals with highcompetitive ranks were involved in aggressive interactions atlower rates than those with low competitive ranks. However,in sympatry, patch-use behavior of occupant G. a. allenbyi individualswas mainly influenced by aggressive behavior of G. pyramidum,which did not respond to their competitive rank. Thus, it shouldpay less for G. a. allenbyi to be aggressive in sympatric populations.The observed reduction in intraspecific aggression among individualG. a. allenbyi in the presence of G. pyramidum supports thisassertion. We suggest that this reduction likely weakens thenegative effect of intra- and interspecific density on the percapita growth rate of G. a. allenbyi. Because this would changethe slope of the isocline of G. a. allenbyi, it could be animportant mechanism promoting coexistence when habitat selectionis constrained.  相似文献   

15.
16.
    
We propose new resampling‐based approaches to construct asymptotically valid time‐simultaneous confidence bands for cumulative hazard functions in multistate Cox models. In particular, we exemplify the methodology in detail for the simple Cox model with time‐dependent covariates, where the data may be subject to independent right‐censoring or left‐truncation. We use simulations to investigate their finite sample behavior. Finally, the methods are utilized to analyze two empirical examples with survival and competing risks data.  相似文献   

17.
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Latent class analysis is an intuitive tool to characterize disease phenotype heterogeneity. With data more frequently collected on multiple phenotypes in chronic disease studies, it is of rising interest to investigate how the latent classes embedded in one phenotype are related to another phenotype. Motivated by a cohort with mild cognitive impairment (MCI) from the Uniform Data Set (UDS), we propose and study a time-dependent structural model to evaluate the association between latent classes and competing risk outcomes that are subject to missing failure types. We develop a two-step estimation procedure which circumvents latent class membership assignment and is rigorously justified in terms of accounting for the uncertainty in classifying latent classes. The new method also properly addresses the realistic complications for competing risks outcomes, including random censoring and missing failure types. The asymptotic properties of the resulting estimator are established. Given that the standard bootstrapping inference is not feasible in the current problem setting, we develop analytical inference procedures, which are easy to implement. Our simulation studies demonstrate the advantages of the proposed method over benchmark approaches. We present an application to the MCI data from UDS, which uncovers a detailed picture of the neuropathological relevance of the baseline MCI subgroups.  相似文献   

19.
    
Differing reproductive effort, individual qualities and local environmental conditions can lead to uneven mortality risk among individuals within populations and may result in survival differences according to age and sex. Identification of factors contributing to unequal operational sex ratios has been important for understanding population dynamics and conservation management. In this study, sex‐ and age‐specific mortality was estimated in three wild Grey Partridge populations from analysis of year‐round radiotracking data from 168 individuals. Survival days were counted in three periods defined individually for each bird: the pairing period (covey break‐up to laying of the first egg); the nesting period (between clutch initiation date and failure of the last nesting attempt, or the date when chicks were 14 days old); and the covey period (the end of the nesting period or joining a group until covey break‐up). Predation was the main cause of mortality. A significant effect of age on survival was found during the pairing period, when older individuals paired off faster and survived better. The highest mortality risk overall was found during the nesting period. Furthermore, significantly higher mortality of females was recorded during the nesting period, suggesting that greater investments in reproduction, behaviour at the nest or the quality of nesting habitats can decrease survival of females and cause a male‐skewed sex ratio. No significant effect of age or sex was found during the covey period, or for the year as a whole, but there was a significant difference in annual mortality rates between the three study populations. Our results confirm age‐ and sex‐specific variation of adult mortality in a ground‐nesting bird with biparental care during the annual cycle, documenting differing sensitivities of various population cohorts to predation.  相似文献   

20.
    
We argue that the term “relative risk” should not be used as a synonym for “hazard ratio” and encourage to use the probabilistic index as an alternative effect measure for Cox regression. The probabilistic index is the probability that the event time of an exposed or treated subject exceeds the event time of an unexposed or untreated subject conditional on the other covariates. It arises as a well known and simple transformation of the hazard ratio and nicely reveals the interpretational limitations. We demonstrate how the probabilistic index can be obtained using the R-package Publish.  相似文献   

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