257 research outputs found

    Maximum likelihood and pseudo score approaches for parametric time-to-event analysis with informative entry times

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    We develop a maximum likelihood estimating approach for time-to-event Weibull regression models with outcome-dependent sampling, where sampling of subjects is dependent on the residual fraction of the time left to developing the event of interest. Additionally, we propose a two-stage approach which proceeds by iteratively estimating, through a pseudo score, the Weibull parameters of interest (i.e., the regression parameters) conditional on the inverse probability of sampling weights; and then re-estimating these weights (given the updated Weibull parameter estimates) through the profiled full likelihood. With these two new methods, both the estimated sampling mechanism parameters and the Weibull parameters are consistently estimated under correct specification of the conditional referral distribution. Standard errors for the regression parameters are obtained directly from inverting the observed information matrix in the full likelihood specification and by either calculating bootstrap or robust standard errors for the hybrid pseudo score/profiled likelihood approach. Loss of efficiency with the latter approach is considered. Robustness of the proposed methods to misspecification of the referral mechanism and the time-to-event distribution is also briefly examined. Further, we show how to extend our methods to the family of parametric time-to-event distributions characterized by the generalized gamma distribution. The motivation for these two approaches came from data on time to cirrhosis from hepatitis C viral infection in patients referred to the Edinburgh liver clinic. We analyze these data here.Comment: Published in at http://dx.doi.org/10.1214/14-AOAS725 the Annals of Applied Statistics (http://www.imstat.org/aoas/) by the Institute of Mathematical Statistics (http://www.imstat.org

    Multiple Imputation of Missing Composite Outcomes in Longitudinal Data.

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    In longitudinal randomised trials and observational studies within a medical context, a composite outcome-which is a function of several individual patient-specific outcomes-may be felt to best represent the outcome of interest. As in other contexts, missing data on patient outcome, due to patient drop-out or for other reasons, may pose a problem. Multiple imputation is a widely used method for handling missing data, but its use for composite outcomes has been seldom discussed. Whilst standard multiple imputation methodology can be used directly for the composite outcome, the distribution of a composite outcome may be of a complicated form and perhaps not amenable to statistical modelling. We compare direct multiple imputation of a composite outcome with separate imputation of the components of a composite outcome. We consider two imputation approaches. One approach involves modelling each component of a composite outcome using standard likelihood-based models. The other approach is to use linear increments methods. A linear increments approach can provide an appealing alternative as assumptions concerning both the missingness structure within the data and the imputation models are different from the standard likelihood-based approach. We compare both approaches using simulation studies and data from a randomised trial on early rheumatoid arthritis patients. Results suggest that both approaches are comparable and that for each, separate imputation offers some improvement on the direct imputation of a composite outcome

    The versatility of multi-state models for the analysis of longitudinal data with unobservable features.

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    Multi-state models provide a convenient statistical framework for a wide variety of medical applications characterized by multiple events and longitudinal data. We illustrate this through four examples. The potential value of the incorporation of unobserved or partially observed states is highlighted. In addition, joint modelling of multiple processes is illustrated with application to potentially informative loss to follow-up, mis-measured or missclassified data and causal inference
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