期刊
STATISTICS IN MEDICINE
卷 35, 期 13, 页码 2195-2205出版社
WILEY
DOI: 10.1002/sim.6853
关键词
recurrent events; dependent censoring; joint frailty models; heart failure
类别
资金
- National Institute for Health Research [PDF-2013-06-024]
- National Institute for Health Research [PDF-2013-06-024] Funding Source: researchfish
- National Institutes of Health Research (NIHR) [PDF-2013-06-024] Funding Source: National Institutes of Health Research (NIHR)
This paper considers the analysis of a repeat event outcome in clinical trials of chronic diseases in the context of dependent censoring (e.g. mortality). It has particular application in the context of recurrent heart failure hospitalisations in trials of heart failure. Semi-parametric joint frailty models (JFMs) simultaneously analyse recurrent heart failure hospitalisations and time to cardiovascular death, estimating distinct hazard ratios whilst individual-specific latent variables induce associations between the two processes. A simulation study was carried out to assess the suitability of the JFM versus marginal analyses of recurrent events and cardiovascular death using standard methods. Hazard ratios were consistently overestimated when marginal models were used, whilst the JFM produced good, well-estimated results. An application to the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity programme was considered. The JFM gave unbiased estimates of treatment effects in the presence of dependent censoring. We advocate the use of the JFM for future trials that consider recurrent events as the primary outcome. (c) 2016 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.
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