• 대한간호학회지
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• 제49권5호
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• pp.575-585
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• 2019

Purpose: The purpose of this study was to develop predictive models for pressure ulcer incidence using electronic health record (EHR) data and to compare their predictive validity performance indicators with that of the Braden Scale used in the study hospital. Methods: A retrospective case-control study was conducted in a tertiary teaching hospital in Korea. Data of 202 pressure ulcer patients and 14,705 non-pressure ulcer patients admitted between January 2015 and May 2016 were extracted from the EHRs. Three predictive models for pressure ulcer incidence were developed using logistic regression, Cox proportional hazards regression, and decision tree modeling. The predictive validity performance indicators of the three models were compared with those of the Braden Scale. Results: The logistic regression model was most efficient with a high area under the receiver operating characteristics curve (AUC) estimate of 0.97, followed by the decision tree model (AUC 0.95), Cox proportional hazards regression model (AUC 0.95), and the Braden Scale (AUC 0.82). Decreased mobility was the most significant factor in the logistic regression and Cox proportional hazards models, and the endotracheal tube was the most important factor in the decision tree model. Conclusion: Predictive validity performance indicators of the Braden Scale were lower than those of the logistic regression, Cox proportional hazards regression, and decision tree models. The models developed in this study can be used to develop a clinical decision support system that automatically assesses risk for pressure ulcers to aid nurses.

• 응용통계연구
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• 제25권2호
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• pp.279-291
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• 2012

공변량에 결측이 발생한 Cox 비례위험 모형을 적합할 때, 결측이 발생하는 개체를 모두 제거한 후 분석을 실시한다면 정보 손실에 의해 비효율적이고 결측의 발생 메커니즘이 완전 임의 결측(missing completely at random; MCAR)이 아니라면 모수의 추정값에 편향이 발생할 수 있다. Cox 비례위험 회귀모형의 공변량에 결측이 있는 경우 적용할 수 있는 여러 가지 방법들이 제안되어져 왔으나 이 분석들은 선택모델(selection model)에 기반하고 있다. 본 연구에서는 Little (1993)이 제안한 패턴-혼합 모델(pattern-mixture model)을 사용하여 Cox 비례위험 회귀모형에서 생존시간과 결측 메커니즘의 결합분포를 모델화 하고, 여러 가지 제약에 근거한 생존 분석의 결과를 비교하였다. 모의실험을 통해서 패턴-혼합 모델의 제약(restrictions)에 따른 모수 추정의 민감도를 확인하였고 결측을 무시한 채 분석한 결과 및 선택모형에 근거한 분석결과와 비교하였다. 패턴-혼합 모델의 제약에 따라 공변량의 결측으로 인한 모수 추정의 민감성 정도를 쥐백혈병 자료 예제를 통해 설명하였다.

• 응용통계연구
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• 제15권2호
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• pp.233-250
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• 2002

Cox의 비례위험모형(proportional hazards model)은 생존자료(survival data)에 대한 회귀모형으로 경제학 및 의·공학을 비롯한 여러 응용 분야에서 가장 널리 쓰이고 있는 모형 중 하나이다. 그러나, 이 모형은 일반선헝모형에 비해 잔차 분석을 통한 회귀 진단의 연구가 널리 알려져 있지 않아, 국내의 실제 자료 분석에서는 잔차 분석에 대한 활용이 거의 이루어지지 않고 있는 실정이다. 이에 본 논문에서는 그 동안 제안된 여러 잔차들을 비교 분석하고, S-plus 프로그램을 이용한 PBC(primary biliary cirrhosis) 자료분석을 통해 각 잔차들의 의미를 고찰하고자 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6751-6755
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• 2013

Background: Research on cancers with a high rate of mortality such as those occurring in the stomach requires using models which can provide a closer examination of disease processes and provide researchers with more accurate data. Various models have been designed based on this issue and the present study aimed at evaluating such models. Materials and Methods: Data from 330 patients with gastric cancer undergoing surgery at Iran Cancer Institute from 1995 to 1999 were analyzed. Cox-Snell Residuals and Akaike Information Criterion were used to compare parametric and semi-parametric Cox models in modeling transition rates among different states of a multi-state model. R 2.15.1 software was used for all data analyses. Results: Analysis of Cox-Snell Residuals and Akaike Information Criterion for all probable transitions among different states revealed that parametric models represented a better fitness. Log-logistic, Gompertz and Log-normal models were good choices for modeling transition rate for relapse hazard (state $1{\rightarrow}state$ 2), death hazard without a relapse (state $1{\rightarrow}state$ 3) and death hazard with a relapse (state $2{\rightarrow}state$ 3), respectively. Conclusions: Although the semi-parametric Cox model is often used by most cancer researchers in modeling transition rates of multistate models, parametric models in similar situations- as they do not need proportional hazards assumption and consider a specific statistical distribution for time to occurrence of next state in case this assumption is not made - are more credible alternatives.

• 응용통계연구
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• 제31권6호
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• pp.761-769
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• 2018

통계학 연구에 모의실험이 중요하게 쓰이며 중도절단자료를 다루는 생존분석에서도 마찬가지다. 생존분석에서 Cox 모형이 널리 쓰이는데, Cox 모형을 따르는 중도절단자료를 생성하는 방법에 대해 살펴보았다. Bender 등 (Statistics in Medicine, 24, 1713-1723, 2005)은 생존시간을 생성하는 모수적 방법을 제시하였으나 생존시간뿐만 아니라 중도절단시간도 생성해야 중도절단자료를 얻게 된다. 중도절단자료를 생성하기 위한 모수적 방법과 함께 비모수적 방법도 제시하였으며 실제 자료에도 적용해 보았다.

• Journal of the Korean Data and Information Science Society
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• 제15권3호
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• pp.605-616
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• 2004

In this paper we consider the proportional hazard models for survival analysis in the microarray data. For a given vector of response values and gene expressions (covariates), we address the issue of how to reduce the dimension by selecting the significant genes. In our approach, rather than fixing the number of selected genes, we will assign a prior distribution to this number. To implement our methodology, we use a Markov Chain Monte Carlo (MCMC) method.

• Asian Pacific Journal of Cancer Prevention
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• 제16권12호
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• pp.5081-5084
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• 2015

Background: Breast cancer is a malignant tumor that starts from cells of the breast and is seen mainly in women. It's the most common cancer in women worldwide and is a major threat to health. The purpose of this study was to fit a Cox proportional hazards model for prediction and determination of years of survival in Iranian patients. Materials and Methods: A total of 366 patients with breast cancer in the Cancer Research Center were included in the study. A Cox proportional hazard model was used with variables such as tumor grade, number of removed positive lymph nodes, human epidermal growth factor receptor 2 (HER2) expression and several other variables. Kaplan-Meier curves were plotted and multi-years of survival were evaluated. Results: The mean age of patients was 48.1 years. Consumption of fatty foods (p=0.033), recurrence (p<0.001), tumor grade (p=0.046) and age (p=0.017) were significant variables. The overall 1- year, 3-year and 5-year survival rates were found to be 93%, 75% and 52%. Conclusions: Use of covariates and the Cox proportional hazard model are effective in predicting the survival of individuals and this model distinguished 4 effective factors in the survival of patients.

• 한국통계학회:학술대회논문집
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• 한국통계학회 2002년도 추계 학술발표회 논문집
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• pp.197-201
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• 2002

The healthy worker effect is an important issue in occupational epidemiology. We proposed a new statistical method to test the relationship between exposure and time to death in the presence of the healthy worker effect. In this study, we considered the healthy worker hire effect to operate as a confounder and the healthy worker survival effect to operate as a confounder and an intermediate variable. The basic idea of the proposed method reflects the length bias-sampling caused by changing one's employment status. Simulation studies were also carried out to compare the proposed method with the Cox proportional hazards models. According to our simulation studies, both the proposed test and the test based on the Cox model having the change of the employment status as a time-dependent covariate seem to be satisfactory at an upper 5% significance level. The Cox models, however, are inadequate with the change, if any, of the employment status as time-independent covariate. The proposed test is superior in power to the test based on the Cox model including the time-dependent employment status.

• Journal of the Korean Statistical Society
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• 제20권1호
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• pp.85-92
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• 1991

A set of conditions ensuring local asymptotic normality for independent but not necessarily identically distributed observations in semiparametric models is presented here. The conditions are turned out to be more direct and easier to verify than those of Oosterhoff and van Zwet(1979) in semiparametric models. Examples considered include the simple linear regression model and Cox's proportional hazards model without censoring where the covariates are not random.

• 한국통계학회:학술대회논문집
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• 한국통계학회 2005년도 춘계 학술발표회 논문집
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• pp.17-23
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• 2005

In this paper we consider the well-known semiparametric proportional hazards models for survival analysis. These models are usually used with few covariates and many observations (subjects). But, for a typical setting of gene expression data from DNA microarray, we need to consider the case where the number of covariates p exceeds the number of samples n. For a given vector of response values which are times to event (death or censored times) and p gene expressions(covariates), we address the issue of how to reduce the dimension by selecting the significant genes. This approach enables us to estimate the survival curve when n ${\ll}$p. In our approach, rather than fixing the number of selected genes, we will assign a prior distribution to this number. The approach creates additional flexibility by allowing the imposition of constraints, such as bounding the dimension via a prior, which in effect works as a penalty To implement our methodology, we use a Markov Chain Monte Carlo (MCMC) method. We demonstrate the use of the methodology to diffuse large B-cell lymphoma (DLBCL) complementary DNA (cDNA) data and Breast Carcinomas data.