Modeling the causal effect of treatment initiation time on survival: Application to HIV/TB co-infection.

ABSTRACT: The timing of antiretroviral therapy (ART) initiation for HIV and tuberculosis (TB) co-infected patients needs to be considered carefully. CD4 cell count can be used to guide decision making about when to initiate ART. Evidence from recent randomized trials and observational studies generally supports early initiation but does not provide information about effects of initiation time on a continuous scale. In this article, we develop and apply a highly flexible structural proportional hazards model for characterizing the effect of treatment initiation time on a survival distribution. The model can be fitted using a weighted partial likelihood score function. Construction of both the score function and the weights must accommodate censoring of the treatment initiation time, the outcome, or b

SUBMITTER: Hu L 

PROVIDER: S-EPMC5874166 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature