Document Detail

Marginal models for clustered time-to-event data with competing risks using pseudovalues.
MedLine Citation:
PMID:  20377579     Owner:  NLM     Status:  MEDLINE    
Many time-to-event studies are complicated by the presence of competing risks and by nesting of individuals within a cluster, such as patients in the same center in a multicenter study. Several methods have been proposed for modeling the cumulative incidence function with independent observations. However, when subjects are clustered, one needs to account for the presence of a cluster effect either through frailty modeling of the hazard or subdistribution hazard, or by adjusting for the within-cluster correlation in a marginal model. We propose a method for modeling the marginal cumulative incidence function directly. We compute leave-one-out pseudo-observations from the cumulative incidence function at several time points. These are used in a generalized estimating equation to model the marginal cumulative incidence curve, and obtain consistent estimates of the model parameters. A sandwich variance estimator is derived to adjust for the within-cluster correlation. The method is easy to implement using standard software once the pseudovalues are obtained, and is a generalization of several existing models. Simulation studies show that the method works well to adjust the SE for the within-cluster correlation. We illustrate the method on a dataset looking at outcomes after bone marrow transplantation.
Brent R Logan; Mei-Jie Zhang; John P Klein
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Biometrics     Volume:  67     ISSN:  1541-0420     ISO Abbreviation:  Biometrics     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-15     Completed Date:  2011-07-11     Revised Date:  2014-09-11    
Medline Journal Info:
Nlm Unique ID:  0370625     Medline TA:  Biometrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-7     Citation Subset:  IM    
Copyright Information:
© 2010, The International Biometric Society.
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MeSH Terms
Biometry / methods*
Cluster Analysis*
Computer Simulation
Data Interpretation, Statistical*
Hematopoietic Stem Cell Transplantation / mortality*
Leukemia, Myeloid, Acute / mortality*,  surgery*
Middle Aged
Models, Statistical*
Risk Assessment / methods
Risk Factors
United States / epidemiology
Young Adult
Grant Support
R01 CA054706/CA/NCI NIH HHS; R01 CA054706-10A1/CA/NCI NIH HHS; R01CA54706-10/CA/NCI NIH HHS

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