• Title/Summary/Keyword: Cox's proportional hazard model

Search Result 112, Processing Time 0.024 seconds

Analysis of Nested Case-Control Study Designs: Revisiting the Inverse Probability Weighting Method

  • Kim, Ryung S.
    • Communications for Statistical Applications and Methods
    • /
    • v.20 no.6
    • /
    • pp.455-466
    • /
    • 2013
  • In nested case-control studies, the most common way to make inference under a proportional hazards model is the conditional logistic approach of Thomas (1977). Inclusion probability methods are more efficient than the conditional logistic approach of Thomas; however, the epidemiology research community has not accepted the methods as a replacement of the Thomas' method. This paper promotes the inverse probability weighting method originally proposed by Samuelsen (1997) in combination with an approximate jackknife standard error that can be easily computed using existing software. Simulation studies demonstrate that this approach yields valid type 1 errors and greater powers than the conditional logistic approach in nested case-control designs across various sample sizes and magnitudes of the hazard ratios. A generalization of the method is also made to incorporate additional matching and the stratified Cox model. The proposed method is illustrated with data from a cohort of children with Wilm's tumor to study the association between histological signatures and relapses.

Estimation of conditional mean residual life function with random censored data (임의중단자료에서의 조건부 평균잔여수명함수 추정)

  • Lee, Won-Kee;Song, Myung-Unn;Jeong, Seong-Hwa
    • Journal of the Korean Data and Information Science Society
    • /
    • v.22 no.1
    • /
    • pp.89-97
    • /
    • 2011
  • The aims of this study were to propose a method of estimation for mean residual life function (MRLF) from conditional survival function using the Buckley and James's (1979) pseudo random variables, and then to assess the performance of the proposed method through the simulation studies. The mean squared error (MSE) of proposed method were less than those of the Cox's proportional hazard model (PHM) and Beran's nonparametric method for non-PHM case. Futhermore in the case of PHM, the MSE's of proposed method were similar to those of Cox's PHM. Finally, to evaluate the appropriateness of practical use, we applied the proposed method to the gastric cancer data. The data set consist of the 1, 192 patients with gastric cancer underwent surgery at the Department of Surgery, K-University Hospital.

Relationship between Delirium and Clinical Prognosis among Older Patients underwent Femur Fracture Surgery (대퇴부골절 후 수술환자의 섬망과 임상예후와의 관계)

  • Shim, Jae-Lan;Hwang, Seon-Young
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.17 no.2
    • /
    • pp.649-656
    • /
    • 2016
  • This study was a retrospective examination to identify the association of postoperative delirium of the prognosis on following femur fracture surgery in elderly patients. Data was collected from the medical records of elderly patients (aged 65 years or older), who underwent femur fracture surgery from July 2010 to January 2014, following on 3-years in one university hospital. A total of 68 patients were involved. There were 31 cases (45.6%) with delirium and 37 cases (54.4%) without delirium. The participant's average age was 80.8 (patients with delirium), and 81.8 (delirium without patients) years of age, respectively, and most of them were female. There was no significant difference between the two groups. Taking five or more medications, serum creatinine level, and the total medical costs were significantly different in the delirium group and non-delirium group. In addition, the proportional hazard model of Cox to determine the predictors for the major clinical outcome occurring after surgery revealed delirium, five or more multi-drug use, and an experience of transfusion to be significant predictors. In conclusion, postoperative delirium in the elderly undergoing femur fracture surgery can have a negative clinical outcome in patients and caregivers. Therefore, a preoperative evaluation and management of the risk factors will be necessary.

Survival analysis on the business types of small business using Cox's proportional hazard regression model (콕스 비례위험 모형을 이용한 중소기업의 업종별 생존율 및 생존요인 분석)

  • Park, Jin-Kyung;Oh, Kwang-Ho;Kim, Min-Soo
    • Journal of the Korean Data and Information Science Society
    • /
    • v.23 no.2
    • /
    • pp.257-269
    • /
    • 2012
  • Global crisis expedites the change in the environment of industry and puts small size enterprises in danger of mass bankruptcy. Because of this, domestic small size enterprises is an urgent need of restructuring. Based on the small business data registered in the Credit Guarantee Fund, we estimated the survival probability in the context of the survival analysis. We also analyzed the survival time which are distinguished depending on the types of business in the small business. Financial variables were also conducted using COX regression analysis of small businesses by types of business. In terms of types of business wholesale and retail trade industry and services were relatively high in the survival probability than light, heavy, and the construction industries. Especially the construction industry showed the lowest survival probability. In addition, we found that construction industry, the bigger BIS (bank of international settlements capital ratio) and current ratio are, the smaller default-rate is. But the bigger borrowing bond is, the bigger default-rate is. In the light industry, the bigger BIS and ROA (return on assets) are, the smaller a default-rate is. In the wholesale and retail trade industry, the bigger bis and current ratio are, the smaller a default-rate is. In the heavy industry, the bigger BIS, ROA, current ratio are, the smaller default-rate is. Finally, in the services industry, the bigger current ratio is, the smaller a default-rate is.

Postoperative Radiotherapy Improves Survival in Gastric Signet-Ring Cell Carcinoma: a SEER Database Analysis

  • Wei, Feng;Lyu, Hongwei;Wang, Shuoer;Chu, Yan;Chen, Fengyuan
    • Journal of Gastric Cancer
    • /
    • v.19 no.4
    • /
    • pp.393-407
    • /
    • 2019
  • Purpose: To identify the potential therapeutic role of postoperative radiotherapy (RT) in patients with locally advanced (stage II and stage III) gastric signet ring cell carcinoma (SRC). Materials and methods: Patients with locally advanced gastric SRC from the Surveillance, Epidemiology, and End Results program database between 2004 and 2012 were included in our study. Univariate and multivariate Cox proportional models were performed, and survival curves were generated to evaluate the prognostic effect of postoperative RT and surgery alone on SRC patients. Propensity score matching (PSM) was used to avoid selection bias among the study cohorts. Results: We found that patients with postoperative RT had better probability of survival compared with those who did not receive RT (overall survival [OS], P<0.001; cancer-specific survival [CSS], P<0.001). After PSM, analysis of both overall and CSS showed that patients who underwent postoperative RT had better prognosis than those receiving surgery alone in the matched cohort (OS, P=0.00079; CSS, P=0.0036). Multivariate Cox proportional model indicated that postoperative RT had better effect on prognosis compared with surgery alone with respect to both overall (hazard ratio [HR], 0.716; 95% confidence interval [95% CI], 0.590-0.87; P=0.001) and CSS (HR, 0.713; 95% CI, 0.570-0.890; P=0.003). Conclusions: Postoperative RT had better prognosis compared with surgery alone for both overall and CSS for patients with locally advanced gastric SRC.

Incidence and Risk Factors of Dyslipidemia after Menopause (폐경 후 이상지질혈증 발생양상과 위험요인)

  • Jeong, Ihn Sook;Yun, Hae Sun;Kim, Myo Sung;Hwang, Youn Sun
    • Journal of Korean Academy of Nursing
    • /
    • v.52 no.2
    • /
    • pp.214-227
    • /
    • 2022
  • Purpose: This study was aimed at investigating the incidence and risk factors of dyslipidemia in menopausal women using a Korean community-based longitudinal study. Methods: The subjects were 245 postmenopausal women without dyslipidemia who had participated in the Ansan-Ansung cohort study from 2001~2002 (baseline) to 2015~2016 (seventh follow-up visit). The dyslipidemia incidence was measured as incidence proportion (%) and incidence rate per 100 person-years. The predictors of developing dyslipidemia were analyzed with Cox's proportional hazard model. Results: The incidence of new dyslipidemia during the follow-up period was 78.4% (192 patients), and 11.9 per 100 person-years. Mean duration from menopause to developing dyslipidemia was 5.3 years in new dyslipidemia cases. The triglyceride/high density lipoprotein (TG/HDL-C) ratio at baseline (hazard ratio = 2.20; 95% confidence interval = 1.39~3.48) was independently associated with developing dyslipidemia. Conclusion: Dyslipidemia occurs frequently in postmenopausal women, principally within five years after menopause. Therefore, steps must be taken to prevent dyslipidemia immediately after menopause, particularly in women with a high TG/HDL-C ratio at the start of menopause.

Association between breastfeeding and early childhood caries: analysis of National Health Insurance Corporation's oral examination data for infants and toddlers (모유수유와 유아기 우식증과의 관련성: 국민건강보험공단 영유아 구강검진 자료 분석)

  • Choi, Yoon-Young
    • Journal of Korean society of Dental Hygiene
    • /
    • v.21 no.2
    • /
    • pp.119-128
    • /
    • 2021
  • Objectives: The aim of this study was to investigate the effect of breastfeeding on the occurrence of early childhood caries in Korean infants and toddlers. Methods: Data on oral examinations of infants and toddlers of the National Health Insurance Service were analyzed. The study subjects were children who participated in both the first, second, and third oral examinations and the first general health examination in 2008-2017 (n=142,185). Based on the responses to the questionnaire, the subjects were classified into breastfeeding, formula feeding, and mixed feeding groups. The participants were monitored for the development of early childhood caries in three sequential oral examinations. Results: Based on the oral examination results conducted at 54-65 months old, the decayed-filled teeth index of the breastfeeding group was the highest (2.03±3.08), followed by the mixed (1.96±3.03) and the formula feeding groups (1.82±2.91). The Cox proportional hazard regression model including all the variables showed that the risk of developing dental caries was significantly lower in the formula (hazard ratio [HR], 0.85) and mixed feeding groups (HR, 0.91) than in the breastfeeding group. Conclusions: Breastfeeding children have a higher risk of early childhood caries; therefore, oral hygiene education and regular dental check-ups are necessary.

Percutaneous Biliary Metallic Stent Insertion in Patients with Malignant Duodenobiliary Obstruction: Outcomes and Factors Influencing Biliary Stent Patency

  • Ji Hye Kwon;Dong Il Gwon;Jong Woo Kim;Hee Ho Chu;Jin Hyoung Kim;Gi-Young Ko;Hyun-Ki Yoon;Kyu-Bo Sung
    • Korean Journal of Radiology
    • /
    • v.21 no.6
    • /
    • pp.695-706
    • /
    • 2020
  • Objective: To investigate the technical and clinical efficacy of the percutaneous insertion of a biliary metallic stent, and to identify the factors associated with biliary stent dysfunction in patients with malignant duodenobiliary obstruction. Materials and Methods: The medical records of 70 patients (39 men and 31 women; mean age, 63 years; range, 38-90 years) who were treated for malignant duodenobiliary obstruction at our institution between April 2007 and December 2018, were retrospectively reviewed. Variables found significant by univariate log-rank analysis (p < 0.2) were considered as suitable candidates for a multiple Cox's proportional hazard model. Results: The biliary stents were successfully placed in all 70 study patients. Biliary stent insertion with subsequent duodenal stent insertion was performed in 33 patients and duodenal stent insertion with subsequent biliary stent insertion was performed in the other 37 study subjects. The median patient survival and stent patency time were 107 days (95% confidence interval [CI], 78-135 days) and 270 days (95% CI, 95-444 days), respectively. Biliary stent dysfunction was observed in 24 (34.3%) cases. Multiple Cox's proportional hazard analysis revealed that the location of the distal biliary stent was the only independent factor affecting biliary stent patency (hazard ratio, 3.771; 95% CI, 1.157-12.283). The median biliary stent patency was significantly longer in patients in whom the distal end of the biliary stent was beyond the distal end of the duodenal stent (median, 327 days; 95% CI, 249-450 days), rather than within the duodenal stent (median, 170 days; 95% CI, 115-225 days). Conclusion: The percutaneous insertion of the biliary metallic stent appears to be a technically feasible, safe, and effective method of treating malignant duodenobiliary obstruction. In addition, a biliary stent system with a distal end located beyond the distal end of the duodenal stent will contribute towards longer stent patency in these patients.

Estimation of the Cure Rate in Iranian Breast Cancer Patients

  • Rahimzadeh, Mitra;Baghestani, Ahmad Reza;Gohari, Mahmood Reza;Pourhoseingholi, Mohamad Amin
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.12
    • /
    • pp.4839-4842
    • /
    • 2014
  • Background: Although the Cox's proportional hazard model is the popular approach for survival analysis to investigate significant risk factors of cancer patient survival, it is not appropriate in the case of log-term disease free survival. Recently, cure rate models have been introduced to distinguish between clinical determinants of cure and variables associated with the time to event of interest. The aim of this study was to use a cure rate model to determine the clinical associated factors for cure rates of patients with breast cancer (BC). Materials and Methods: This prospective cohort study covered 305 patients with BC, admitted at Shahid Faiazbakhsh Hospital, Tehran, during 2006 to 2008 and followed until April 2012. Cases of patient death were confirmed by telephone contact. For data analysis, a non-mixed cure rate model with Poisson distribution and negative binomial distribution were employed. All analyses were carried out using a developed Macro in WinBugs. Deviance information criteria (DIC) were employed to find the best model. Results: The overall 1-year, 3-year and 5-year relative survival rates were 97%, 89% and 74%. Metastasis and stage of BC were the significant factors, but age was significant only in negative binomial model. The DIC also showed that the negative binomial model had a better fit. Conclusions: This study indicated that, metastasis and stage of BC were identified as the clinical criteria for cure rates. There are limited studies on BC survival which employed these cure rate models to identify the clinical factors associated with cure. These models are better than Cox, in the case of long-term survival.

Treatment outcome and risk analysis for cataract after radiotherapy of localized ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma

  • Park, Hee Hyun;Lee, Sea-Won;Sung, Soo Yoon;Choi, Byung Ock
    • Radiation Oncology Journal
    • /
    • v.35 no.3
    • /
    • pp.249-256
    • /
    • 2017
  • Purpose: We retrospectively reviewed the results of radiotherapy for localized ocular adnexal MALT lymphoma (OAML) to investigate the risk factors of cataract. Methods: Sixty-seven patients with stage IE OAML treated with radiotherapy at Seoul St. Mary's Hospital from 2001 to 2016 were included. Median treatment dose was 30 Gy. Lens protection was done in 52 (76%) patients. Radiation therapy (RT) extent was as follows: superficial (82.1%), tumor mass (4.5%), and entire orbital socket (13.4%). The risk factors for symptomatic cataract were analyzed using the Cox proportional hazard model. Results: Median follow-up time was 50.9 months (range, 1.9 to 149.4 months). All patients were alive at the time of analysis. There were 7 recurrences and there was no local recurrence. Median time to recurrence was 40.4 months. There were 14 cases of symptomatic cataract. Dose >30 Gy had hazard ratio of 3.47 for cataract (p = 0.026). Omitting lens protection showed hazard ratio of 4.10 (p = 0.008). Conclusions: RT achieves excellent local control of ocular MALT lymphoma. Consideration of RT-related factors such as lens protection and radiation dose at the stage of RT planning may reduce the risk of RT-induced cataract after radiotherapy.