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Estimation with Cox models: cause-specific survival analysis with misclassified cause of failure

Authors
  • Van Rompaye, Bart
  • Jaffar, Shabbar
  • Goetghebeur, Els
Publication Date
Jan 01, 2012
Source
Ghent University Institutional Archive
Keywords
Language
English
License
Unknown
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Abstract

While epidemiologic and clinical research often aims to analyze predictors of specific endpoints, time-to-the-specific-event analysis can be hampered by problems with cause ascertainment. Under typical assumptions of competing risks analysis (and missing-data settings), we correct the cause-specific proportional hazards analysis when information on the reliability of diagnosis is available. Our method avoids bias in effect estimates at low cost in variance, thus offering a perspective for better-informed decision making. The ratio of different cause-specific hazards can be estimated flexibly for this purpose. It thus complements an all-cause analysis. In a sensitivity analysis, this approach can reveal the likely extent and direction of the bias of a standard cause-specific analysis when the diagnosis is suspect. These 2 uses are illustrated in a randomized vaccine trial and an epidemiologic cohort study, respectively.

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