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

A mixed model approach for structured hazard regression

The classical Cox proportional hazards model is a benchmark approach to analyze continuous survival times in the presence of covariate information. In a number of applications, there is a need to relax one or more of its inherent assumptions, such as linearity of the predictor or the proportional hazards property. Also, one is often interested in jointly estimating the baseline hazard together with covariate effects or one may wish to add a spatial component for spatially correlated survival data. We propose an extended Cox model, where the (log-)baseline hazard is weakly parameterized using penalized splines and the usual linear predictor is replaced by a structured additive predictor incorporating nonlinear effects of continuous covariates and further time scales, spatial effects, frailty components, and more complex interactions. Inclusion of time-varying coefficients leads to models that relax the proportional hazards assumption. Nonlinear and time-varying effects are modelled through penalized splines, and spatial components are treated as correlated random effects following either a Markov random field or a stationary Gaussian random field. All model components, including smoothing parameters, are specified within a unified framework and are estimated simultaneously based on mixed model methodology. The estimation procedure for such general mixed hazard regression models is derived using penalized likelihood for regression coefficients and (approximate) marginal likelihood for smoothing parameters. Performance of the proposed method is studied through simulation and an application to leukemia survival data in Northwest England

Joint modeling of longitudinal drug using pattern and time to first relapse in cocaine dependence treatment data

An important endpoint variable in a cocaine rehabilitation study is the time to first relapse of a patient after the treatment. We propose a joint modeling approach based on functional data analysis to study the relationship between the baseline longitudinal cocaine-use pattern and the interval censored time to first relapse. For the baseline cocaine-use pattern, we consider both self-reported cocaine-use amount trajectories and dichotomized use trajectories. Variations within the generalized longitudinal trajectories are modeled through a latent Gaussian process, which is characterized by a few leading functional principal components. The association between the baseline longitudinal trajectories and the time to first relapse is built upon the latent principal component scores. The mean and the eigenfunctions of the latent Gaussian process as well as the hazard function of time to first relapse are modeled nonparametrically using penalized splines, and the parameters in the joint model are estimated by a Monte Carlo EM algorithm based on Metropolis-Hastings steps. An Akaike information criterion (AIC) based on effective degrees of freedom is proposed to choose the tuning parameters, and a modified empirical information is proposed to estimate the variance-covariance matrix of the estimators.Comment: Published at http://dx.doi.org/10.1214/15-AOAS852 in the Annals of Applied Statistics (http://www.imstat.org/aoas/) by the Institute of Mathematical Statistics (http://www.imstat.org

Mixed Model-Based Hazard Estimation.

We propose a new method for estimation of the hazard function from a set of censored failure time data, with a view to extending the general approach to more complicated models. The approach is based on a mixed model representation of penalized spline hazard estimators. One payoff is the automation of the smoothing parameter choice through restricted maximum likelihood. Another is the option to use standard mixed model software for automatic hazard estimation.Non-parametric regression; Restricted maximum likelihood; Variance component; Survival analysis.

Multiple imputation approach for interval-censored time to HIV RNA viral rebound within a mixed effects Cox model

This is the peer reviewed version of the following article: “Alarcón-Soto, Y, Langohr K., Fehér, C., García, F., and Gómez, G. (2018) Multiple imputation approach for interval-censored time to HIV RNA viral rebound within a mixed effects Cox Model.Biometrical journal, December 13th ”which has been published in final form at [doi: 10.1002/bimj.201700291]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.We present a method to fit a mixed effects Cox model with interval-censored data. Our proposal is based on a multiple imputation approach that uses the truncated Weibull distribution to replace the interval-censored data by imputed survival times and then uses established mixed effects Cox methods for right-censored data. Interval-censored data were encountered in a database corresponding to a recompilation of retrospective data from eight analytical treatment interruption (ATI) studies in 158 human immunodeficiency virus (HIV) positive combination antiretroviral treatment (cART) suppressed individuals. The main variable of interest is the time to viral rebound, which is defined as the increase of serum viral load (VL) to detectable levels in a patient with previously undetectable VL, as a consequence of the interruption of cART. Another aspect of interest of the analysis is to consider the fact that the data come from different studies based on different grounds and that we have several assessments on the same patient. In order to handle this extra variability, we frame the problem into a mixed effects Cox model that considers a random intercept per subject as well as correlated random intercept and slope for pre-cART VL per study. Our procedure has been implemented in R using two packages: truncdist and coxme, and can be applied to any data set that presents both interval-censored survival times and a grouped data structure that could be treated as a random effect in a regression model. The properties of the parameter estimators obtained with our proposed method are addressed through a simulation study.Peer ReviewedPostprint (author's final draft