simultaneous inference

  • 文章类型: Journal Article
    For many forms of cancer, patients will receive the initial regimen of treatments, then experience cancer progression and eventually die of the disease. Understanding the disease process in patients with cancer is essential in clinical, epidemiological and translational research. One challenge in analyzing such data is that death dependently censors cancer progression (e.g., recurrence), whereas progression does not censor death. We deal with the informative censoring by first selecting a suitable copula model through an exploratory diagnostic approach and then developing an inference procedure to simultaneously estimate the marginal survival function of cancer relapse and an association parameter in the copula model. We show that the proposed estimators possess consistency and weak convergence. We use simulation studies to evaluate the finite sample performance of the proposed method, and illustrate it through an application to data from a study of early stage breast cancer.
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  • 文章类型: Journal Article
    对于使用事件发生时间数据的临床试验和观察性研究中的风险和收益评估,Cox模型通常是首选模型。当危险可能不成比例时,可以考虑在时间轴的分区上的分段Cox模型。这里,我们建议使用特定的半参数模型分析临床试验或观察性研究与事件发生时间数据。该模型允许时间依赖的治疗效果。它包括重要的比例风险模型作为子模型,并且可以适应风险比的时间依赖性的各种模式。在使用伪似然方法估计模型参数之后,使用蒙特卡罗方法建立风险比函数的同时置信区间,以评估治疗效果的时变模式。评估整体治疗效果,还获得了估计的平均风险比及其置信区间。所提出的方法适用于妇女健康倡议的数据。比较妇女健康倡议临床试验和观察性研究,我们在建立回归模型时使用倾向得分。与分段Cox模型相比,所提出的模型产生更好的模型拟合,并且不需要对时间轴进行划分。
    For risk and benefit assessment in clinical trials and observational studies with time-to-event data, the Cox model has usually been the model of choice. When the hazards are possibly non-proportional, a piece-wise Cox model over a partition of the time axis may be considered. Here, we propose to analyze clinical trials or observational studies with time-to-event data using a certain semiparametric model. The model allows for a time-dependent treatment effect. It includes the important proportional hazards model as a sub-model and can accommodate various patterns of time-dependence of the hazard ratio. After estimation of the model parameters using a pseudo-likelihood approach, simultaneous confidence intervals for the hazard ratio function are established using a Monte Carlo method to assess the time-varying pattern of the treatment effect. To assess the overall treatment effect, estimated average hazard ratio and its confidence intervals are also obtained. The proposed methods are applied to data from the Women\'s Health Initiative. To compare the Women\'s Health Initiative clinical trial and observational study, we use the propensity score in building the regression model. Compared with the piece-wise Cox model, the proposed model yields a better model fit and does not require partitioning of the time axis.
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