Dataset Information

FLEXIBLE RISK PREDICTION MODELS FOR LEFT OR INTERVAL-CENSORED DATA FROM ELECTRONIC HEALTH RECORDS.

ABSTRACT: Electronic health records are a large and cost-effective data source for developing risk-prediction models. However, for screen-detected diseases, standard risk models (such as Kaplan-Meier or Cox models) do not account for key issues encountered with electronic health record data: left-censoring of pre-existing (prevalent) disease, interval-censoring of incident disease, and ambiguity of whether disease is prevalent or incident when definitive disease ascertainment is not conducted at baseline. Furthermore, researchers might conduct novel screening tests only on a complex two-phase subsample. We propose a family of weighted mixture models that account for left/interval-censoring and complex sampling via inverse-probability weighting in order to estimate current and future absolute risk: we propose a weakly-parametric model for general use and a semiparametric model for checking goodness of fit of the weakly-parametric model. We demonstrate asymptotic properties analytically and by simulation. We used electronic health records to assemble a cohort of 33,295 human papillomavirus (HPV) positive women undergoing cervical cancer screening at Kaiser Permanente Northern California (KPNC) that underlie current screening guidelines. The next guidelines would focus on HPV typing tests, but reporting 14 HPV types is too complex for clinical use. National Cancer Institute along with KPNC conducted a HPV typing test on a complex subsample of 9258 women in the cohort. We used our model to estimate the risk due to each type and grouped the 14 types (the 3-year risk ranges 21.9-1.5) into 4 risk-bands to simplify reporting to clinicians and guidelines. These risk-bands could be adopted by future HPV typing tests and future screening guidelines.

SUBMITTER: Hyun N

PROVIDER: S-EPMC6586434 | biostudies-other | 2017 Jun

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

FLEXIBLE RISK PREDICTION MODELS FOR LEFT OR INTERVAL-CENSORED DATA FROM ELECTRONIC HEALTH RECORDS.

Hyun Noorie N Cheung Li C LC Pan Qing Q Schiffman Mark M Katki Hormuzd A HA

The annals of applied statistics 20170601 2

Electronic health records are a large and cost-effective data source for developing risk-prediction models. However, for screen-detected diseases, standard risk models (such as Kaplan-Meier or Cox models) do not account for key issues encountered with electronic health record data: left-censoring of pre-existing (prevalent) disease, interval-censoring of incident disease, and ambiguity of whether disease is prevalent or incident when definitive disease ascertainment is not conducted at baseline. ...[more]

PMID: 31223347

Similar Datasets

Project description:BackgroundTime-to-event data that is subject to interval censoring is common in the practice of medical research and versatile statistical methods for estimating associations in such settings have been limited. For right censored data, non-parametric pseudo-observations have been proposed as a basis for regression modeling with the possibility to use different association measures. In this article, we propose a method for calculating pseudo-observations for interval censored data.MethodsWe develop an extension of a recently developed set of parametric pseudo-observations based on a spline-based flexible parametric estimator. The inherent competing risk issue with an interval censored event of interest necessitates the use of an illness-death model, and we formulate our method within this framework. To evaluate the empirical properties of the proposed method, we perform a simulation study and calculate pseudo-observations based on our method as well as alternative approaches. We also present an analysis of a real dataset on patients with implantable cardioverter-defibrillators who are monitored for the occurrence of a particular type of device failures by routine follow-up examinations. In this dataset, we have information on exact event times as well as the interval censored data, so we can compare analyses of pseudo-observations based on the interval censored data to those obtained using the non-parametric pseudo-observations for right censored data.ResultsOur simulations show that the proposed method for calculating pseudo-observations provides unbiased estimates of the cumulative incidence function as well as associations with exposure variables with appropriate coverage probabilities. The analysis of the real dataset also suggests that our method provides estimates which are in agreement with estimates obtained from the right censored data.ConclusionsThe proposed method for calculating pseudo-observations based on the flexible parametric approach provides a versatile solution to the specific challenges that arise with interval censored data. This solution allows regression modeling using a range of different association measures.

Dataset Information

FLEXIBLE RISK PREDICTION MODELS FOR LEFT OR INTERVAL-CENSORED DATA FROM ELECTRONIC HEALTH RECORDS.

Publications

FLEXIBLE RISK PREDICTION MODELS FOR LEFT OR INTERVAL-CENSORED DATA FROM ELECTRONIC HEALTH RECORDS.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure