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2016 ; 72
(2
): 525-34
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Semiparametric methods to contrast gap time survival functions: Application to
repeat kidney transplantation
#MMPMID26501480
Shu X
; Schaubel DE
Biometrics
2016[Jun]; 72
(2
): 525-34
PMID26501480
show ga
Times between successive events (i.e., gap times) are of great importance in
survival analysis. Although many methods exist for estimating covariate effects
on gap times, very few existing methods allow for comparisons between gap times
themselves. Motivated by the comparison of primary and repeat transplantation,
our interest is specifically in contrasting the gap time survival functions and
their integration (restricted mean gap time). Two major challenges in gap time
analysis are non-identifiability of the marginal distributions and the existence
of dependent censoring (for all but the first gap time). We use Cox regression to
estimate the (conditional) survival distributions of each gap time (given the
previous gap times). Combining fitted survival functions based on those models,
along with multiple imputation applied to censored gap times, we then contrast
the first and second gap times with respect to average survival and restricted
mean lifetime. Large-sample properties are derived, with simulation studies
carried out to evaluate finite-sample performance. We apply the proposed methods
to kidney transplant data obtained from a national organ transplant registry.
Mean 10-year graft survival of the primary transplant is significantly greater
than that of the repeat transplant, by 3.9 months (p=0.023), a result that may
lack clinical importance.
|*Data Interpretation, Statistical
[MESH]
|*Models, Statistical
[MESH]
|*Proportional Hazards Models
[MESH]
|Computer Simulation
[MESH]
|Graft Survival
[MESH]
|Humans
[MESH]
|Kidney Transplantation/mortality/*statistics & numerical data
[MESH]