• Title/Summary/Keyword: competing risk analysis

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Risk of Death and Occurrence of Secondary Disease of Cancer and Cardiovascular Disease Patient by Income Level in Korea (암, 심뇌혈관 질환자의 소득수준에 따른 사망 및 이차 질환 발생 위험)

  • Kang, Minjin;Son, Kangju
    • The Journal of the Korea Contents Association
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    • v.18 no.10
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    • pp.145-157
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    • 2018
  • In this study, we analyzed the effect of the income level of cancer, stroke, and myocardial infarction on mortality by using National Health Insurance Service(NHIS) Cohort 2.0 DB. Patients who newly developed the disease in 2007 were observed till 2015. The analysis used the Cox probability proportional risk model and the competing risk model. The income level used information at the time of the onset of the disease in 2007, categorized into low / mid / high. The results showed that there were differences in the risks of death and secondary disease in patients with cancer, stroke, or myocardial infarction according to the income level. In addition to the need for a social safety net to lower the incidence of early deaths in low-income families, it seems necessary to continue to strengthen universal protection for serious diseases similar to the current policy.

Bioprosthesis in the Mitral Position: Bovine Pericardial versus Porcine Xenograft

  • Han, Dong Youb;Park, Sung Jun;Kim, Ho Jin;Jung, Sung-Ho;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won;Kim, Joon Bum
    • Journal of Chest Surgery
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    • v.55 no.1
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    • pp.69-76
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    • 2022
  • Background: While the use of bioprosthetic valves for mitral valve replacement (MVR) is increasing, very few studies have compared bovine pericardial and porcine valves in the mitral position to help guide bioprosthetic selection. Methods: In the present study, patients who underwent MVR using bovine pericardial valves were compared with those who underwent MVR with porcine bioprostheses between January 1996 and July 2018. Those with prior MVR, infective endocarditis, congenital mitral valve disease, or ischemic mitral regurgitation were excluded. The primary outcomes were structural valve deterioration (SVD) and mitral valve reoperation from any cause, and death was regarded as a competing risk. Competing risk analysis and propensity score-matching were used for comparisons. Results: Among the 388 patients enrolled, pericardial and porcine bioprostheses were implanted in 217 (55.9%) and 171 (44.1%), respectively. Propensity score-matching yielded 122 pairs of patients that were well-balanced for all baseline covariates. No significant differences were observed between the groups in unadjusted (p=0.09) and adjusted overall survival (hazard ratio [HR], 1.13; 95% confidence interval [CI], 0.72-1.76; p=0.60). Competing risk analysis revealed no significant differences in the risks of mitral reoperation (HR, 1.07; 95% CI, 0.50-2.27; p=0.86) and development of SVD (HR, 1.57; 95% CI, 0.56-4.36; p=0.39) between the groups. Matched population analysis confirmed similar results regarding reoperation (HR, 0.99; 95% CI, 0.40-3.22; p=0.98) and SVD (HR, 1.39; 95% CI, 0.41-4.73; p=0.60). Conclusion: No significant differences in survival or valve durability were observed between bovine pericardial and porcine bioprosthetic MVR. These findings require further validation through studies with larger sample sizes.

Analysis of generalized progressive hybrid censored competing risks data

  • Lee, Kyeong-Jun;Lee, Jae-Ik;Park, Chan-Keun
    • Journal of Advanced Marine Engineering and Technology
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    • v.40 no.2
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    • pp.131-137
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    • 2016
  • In reliability analysis, it is quite common for the failure of any individual or item to be attributable to more than one cause. Moreover, observed data are often censored. Recently, progressive hybrid censoring schemes have become quite popular in life-testing problems and reliability analysis. However, a limitation of the progressive hybrid censoring scheme is that it cannot be applied when few failures occur before time T. Therefore, generalized progressive hybrid censoring schemes have been introduced. In this article, we derive the likelihood inference of the unknown parameters under the assumptions that the lifetime distributions of different causes are independent and exponentially distributed. We obtain the maximum likelihood estimators of the unknown parameters in exact forms. Asymptotic confidence intervals are also proposed. Bayes estimates and credible intervals of the unknown parameters are obtained under the assumption of gamma priors on the unknown parameters. Different methods are compared using Monte Carlo simulations. One real data set is analyzed for illustrative purposes.

Analysis of the cause-specific proportional hazards model with missing covariates (누락된 공변량을 가진 원인별 비례위험모형의 분석)

  • Minjung Lee
    • The Korean Journal of Applied Statistics
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    • v.37 no.2
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    • pp.225-237
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    • 2024
  • In the analysis of competing risks data, some of covariates may not be fully observed for some subjects. In such cases, excluding subjects with missing covariate values from the analysis may result in biased estimates and loss of efficiency. In this paper, we studied multiple imputation and the augmented inverse probability weighting method for regression parameter estimation in the cause-specific proportional hazards model with missing covariates. The performance of estimators obtained from multiple imputation and the augmented inverse probability weighting method is evaluated by simulation studies, which show that those methods perform well. Multiple imputation and the augmented inverse probability weighting method were applied to investigate significant risk factors for the risk of death from breast cancer and from other causes for breast cancer data with missing values for tumor size obtained from the Prostate, Lung, Colorectal, and Ovarian Cancer Screen Trial Study. Under the cause-specific proportional hazards model, the methods show that race, marital status, stage, grade, and tumor size are significant risk factors for breast cancer mortality, and stage has the greatest effect on increasing the risk of breast cancer death. Age at diagnosis and tumor size have significant effects on increasing the risk of other-cause death.

Mechanical versus Bioprosthetic Aortic Valve Replacement in Patients Aged 50 to 70 Years

  • Youngkwan Song;Ki Tae Kim;Soo Jin Park;Hong Rae Kim;Jae Suk Yoo;Pil Je Kang;Sung-Ho Jung;Cheol Hyun Chung;Joon Bum Kim;Ho Jin Kim
    • Journal of Chest Surgery
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    • v.57 no.3
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    • pp.242-251
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    • 2024
  • Background: This study compared the outcomes of surgical aortic valve replacement (AVR) in patients aged 50 to 70 years based on the type of prosthetic valve used. Methods: We compared patients who underwent mechanical AVR to those who underwent bioprosthetic AVR at our institution between January 2000 and March 2019. Competing risk analysis and the inverse probability of treatment weighting (IPTW) method based on propensity score were employed for comparisons. Results: A total of 1,580 patients (984 patients with mechanical AVR; 596 patients with bioprosthetic AVR) were enrolled. There was no significant difference in early mortality between the mechanical AVR and bioprosthetic AVR groups (0.9% vs. 1.7%, p=0.177). After IPTW adjustment, the risk of all-cause mortality was significantly higher in the bioprosthetic AVR group than in the mechanical AVR group (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.07-1.80; p=0.014). Competing risk analysis revealed lower risks of stroke (sub-distributional hazard ratio [sHR], 0.44; 95% CI, 0.28-0.67; p<0.001) and anticoagulation-related bleeding (sHR, 0.35; 95% CI, 0.23-0.53; p<0.001) in the bioprosthetic AVR group. Conversely, the risk of aortic valve (AV) reintervention was higher in the bioprosthetic AVR group (sHR, 6.14; 95% CI, 3.17-11.93; p<0.001). Conclusion: Among patients aged 50 to 70 years who underwent surgical AVR, those receiving mechanical valves showed better survival than those with bioprosthetic valves. The mechanical AVR group exhibited a higher risk of stroke and anticoagulation-related bleeding, while the bioprosthetic AVR group showed a higher risk of AV reintervention.

Fitting competing risks models using medical big data from tuberculosis patients (전국 결핵 신환자 의료빅데이터를 이용한 경쟁위험모형 적합)

  • Kim, Gyeong Dae;Noh, Maeng Seok;Kim, Chang Hoon;Ha, Il Do
    • The Korean Journal of Applied Statistics
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    • v.31 no.4
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    • pp.529-538
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    • 2018
  • Tuberculosis causes high morbidity and mortality. However, Korea still has the highest tuberculosis (TB) incidence and mortality among OECD countries despite decreasing incidence and mortality due to the development of modern medicine. Korea has now implemented various policy projects to prevent and control tuberculosis. This study analyzes the effects of public-private mix (PPM) tuberculosis control program on treatment outcomes and identifies the factors that affecting the success of TB treatment. We analyzed 130,000 new tuberculosis patient cohort from 2012 to 2015 using data of tuberculosis patient reports managed by the Disease Control Headquarters. A cumulative incidence function (CIF) compared the cumulative treatment success rates for each factor. We compared the results of the analysis using two popular types of competition risk models (cause-specific Cox's proportional hazards model and subdistribution hazard model) that account for the main event of interest (treatment success) and competing events (death).

Application of the Weibull-Poisson long-term survival model

  • Vigas, Valdemiro Piedade;Mazucheli, Josmar;Louzada, Francisco
    • Communications for Statistical Applications and Methods
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    • v.24 no.4
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    • pp.325-337
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    • 2017
  • In this paper, we proposed a new long-term lifetime distribution with four parameters inserted in a risk competitive scenario with decreasing, increasing and unimodal hazard rate functions, namely the Weibull-Poisson long-term distribution. This new distribution arises from a scenario of competitive latent risk, in which the lifetime associated to the particular risk is not observable, and where only the minimum lifetime value among all risks is noticed in a long-term context. However, it can also be used in any other situation as long as it fits the data well. The Weibull-Poisson long-term distribution is presented as a particular case for the new exponential-Poisson long-term distribution and Weibull long-term distribution. The properties of the proposed distribution were discussed, including its probability density, survival and hazard functions and explicit algebraic formulas for its order statistics. Assuming censored data, we considered the maximum likelihood approach for parameter estimation. For different parameter settings, sample sizes, and censoring percentages various simulation studies were performed to study the mean square error of the maximum likelihood estimative, and compare the performance of the model proposed with the particular cases. The selection criteria Akaike information criterion, Bayesian information criterion, and likelihood ratio test were used for the model selection. The relevance of the approach was illustrated on two real datasets of where the new model was compared with its particular cases observing its potential and competitiveness.

A Study on the Fire Safety Plan for High-Rise Building Construction (초고층 건축물 건설공사 시 화재안전계획 수립에 관한 연구)

  • Ham, Eun-Gu;Jeong, Myeong-Jin;Lee, Myeong-Gu
    • Proceedings of the Safety Management and Science Conference
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    • 2012.11a
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    • pp.59-66
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    • 2012
  • Recently buildings are constructed in larger and higher scales and becoming more complex. Every country in the world is competing to build high-rise buildings. Korea also has and is constructing high-rise buildings, like the 123story Jamsil Lotte Super Tower. However from small to large scale buildings and on construction sites there still are fire safety accidents that occur continuously. Therefore to improve fire safety plan, examining the actual fire safety management and understanding fire risk analysis Using Fire Modeling through Computer Simulation. Fire safety management plan related fire safety cases were collected an dan analyzed for the study. Also hazard analysis of High rise Buildings under fire compared with existing fire law sand regulations.

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Meta-Analysis of Information Privacy Using TSSEM (TSSEM을 이용한 정보 프라이버시 메타분석)

  • Kim, Jongki
    • Journal of Digital Convergence
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    • v.17 no.11
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    • pp.149-156
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    • 2019
  • With widespread use of information technologies, information privacy issues have been gaining more attention by not only the public but also researchers. The number of studies on the issues has been increasing exponentially, which makes incomprehensible the whole picture of research outcome. Thus, it is necessary to conduct a systematic examination of past research. This study developed two competing models with four essential constructs in information privacy research and empirically tested the models with data obtained from previous studies. This study employed a quantitative meta-analysis method called TSSEM. It is one of MASEM methods in which structural equation modeling and meta-analysis are integrated. The analysis results indicated that risk-centric model exhibited much better model fits than those of concern-centric model. This study implies that traditional concern-centric model should be questioned it's explanatory power of the model and researchers may consider alternative risk-centric model to explain user's intention to provide privacy information.

Current status of alert alien species management for the establishment of proactive management systems in Korea

  • Son, Seung Hun;Jo, A-Ram;Kim, Dong Eon
    • Journal of Ecology and Environment
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    • v.45 no.4
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    • pp.237-254
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    • 2021
  • Background: Some of the introduced alien species introduced settle, multiply, and spread to become invasive alien species (IAS) that threaten biodiversity. To prevent this, Korea and other countries legally designate and manage alien species that pose a risk to the environment. Moreover, 2160 alien species have been introduced in South Korea, of which 1826 animals and 334 plants are designated. The inflow of IAS can have negative effects such as ecosystem disturbance, habitat destruction, economic damage, and health damage to humans. To prevent damage caused by the inflow of IAS in advance, species that could potentially pose a risk to the environment if introduced in South Korea were designated as alert alien species (AAS). Results: The designation criteria were in accordance with the "Act on the Conservation and Use of Biological Diversity" and the "Regulations on the Ecological Risk Assessment of AAS and IAS" by the National Institute of Ecology. The analysis result of risk and damage cases indicated that mammals affect predation, competition, human economic activity, virus infection, and parasite infection. Birds have been demonstrated to affect predation, competition, human economic activity, and health. It was indicated that plants intrude on the ecosystem by competing with native species with their high-population density and capacity to multiply and cause allergic inducement. Interestingly, 300 species, including 25 mammals, 7 birds, 84 fishes, 28 amphibians, 22 reptiles, 1 insect, 32 spiders, 1 mollusk, 1 arthropod, and 99 plants, are included in the list of AAS. Conclusions: AAS designation plays a role in preventing the reduction of biodiversity by IAS in South Korea and preserving native species. Moreover, it is determined to provide considerable economic benefits by preventing socio-economic losses and ecological damage.