Geoadditive hazard regression for interval censored survival times

The Cox proportional hazards model is the most commonly used method when analyzing the impact of covariates on continuous survival times. In its classical form, the Cox model was introduced in the setting of right-censored observations. However, in practice other sampling schemes are frequently encountered and therefore extensions allowing for interval and left censoring or left truncation are clearly desired. Furthermore, many applications require a more flexible modeling of covariate information than the usual linear predictor. For example, effects of continuous covariates are likely to be of nonlinear form or spatial information is to be included appropriately. Further extensions should allow for time-varying effects of covariates or covariates that are themselves time-varying. Such models relax the assumption of proportional hazards. We propose a regression model for the hazard rate that combines and extends the above-mentioned features on the basis of a unifying Bayesian model formulation. Nonlinear and time-varying effects as well as the baseline hazard rate are modeled by penalized splines. Spatial effects can be included based on either Markov random fields or stationary Gaussian random fields. The model allows for arbitrary combinations of left, right and interval censoring as well as left truncation. Estimation is based on a reparameterisation of the model as a variance components mixed model. The variance parameters corresponding to inverse smoothing parameters can then be estimated based on an approximate marginal likelihood approach. As an application we present an analysis on childhood mortality in Nigeria, where the interval censoring framework also allows to deal with the problem of heaped survival times caused by memory effects. In a simulation study we investigate the effect of ignoring the impact of interval censored observations

Parametrization and penalties in spline models with an application to survival analysis

In this paper we show how a simple parametrization, built from the definition of cubic splines, can aid in the implementation and interpretation of penalized spline models, whatever configuration of knots we choose to use. We call this parametrization value-first derivative parametrization. We perform Bayesian inference by exploring the natural link between quadratic penalties and Gaussian priors. However, a full Bayesian analysis seems feasible only for some penalty functionals. Alternatives include empirical Bayes methods involving model selection type criteria. The proposed methodology is illustrated by an application to survival analysis where the usual Cox model is extended to allow for time-varying regression coefficients

Building Cox-Type Structured Hazard Regression Models with Time-Varying Effects

In recent years, flexible hazard regression models based on penalised splines have been developed that allow us to extend the classical Cox-model via the inclusion of time-varying and nonparametric effects. Despite their immediate appeal in terms of flexibility, these models introduce additional difficulties when a subset of covariates and the corresponding modelling alternatives have to be chosen. We present an analysis of data from a specific patient population with 90-day survival as the response variable. The aim is to determine a sensible prognostic model where some variables have to be included due to subject-matter knowledge while other variables are subject to model selection. Motivated by this application, we propose a twostage stepwise model building strategy to choose both the relevant covariates and the corresponding modelling alternatives within the choice set of possible covariates simultaneously. For categorical covariates, competing modelling approaches are linear effects and time-varying effects, whereas nonparametric modelling provides a further alternative in case of continuous covariates. In our data analysis, we identified a prognostic model containing both smooth and time-varying effects