Calibration regression of censored lifetime medical cost
Calibration regression of censored lifetime medical cost
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DOI：
10.1198/016214502753479446
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发表时间：
2002-03-01
影响因子：
3.7
通讯作者：
Huang, YJ
中科院分区：
文献类型：
--
作者：
Huang, YJ
终生医疗费用的分析受到不规则分布和不完整随访的挑战，特别是后者研究持续时间有限，这是医学研究中典型的情况。本文提出了所谓的校准回归，通过以半参数方式对终生医疗成本和生存时间进行建模来解决这些问题。假设在可能变换的尺度上，这两种结果都与协变量线性相关，但是，双变量模型误差分布完全未指定。虽然这个概念上简单的模型是加速失效时间模型的自然多元推广，但本文通过将加权对数秩估计函数扩展到标记点过程框架，提出了一种推理过程，所得估计量是一致的且渐近正态的。此外，还讨论了鲁棒性和效率问题。此外，一般来说，为基于非平滑估计函数的估计器提出了一种新颖的基于样本的方差估计过程。最后，仿真研究表明该方案在实际应用中是可靠的。提供了应用于肺癌临床试验的示例。
Analysis of lifetime medical cost is challenged by its irregular distribution and by incomplete follow-up, particularly the latter with limited study duration as is typical in medical research. This article proposes the so-called calibration regression to address these issues by modeling not only lifetime medical cost but also survival time, in a semiparametric fashion. It is postulated that both outcomes, on possibly transformed scales, linearly relate to the covariates however, the bivariate model error distribution is completely unspecified. Whereas this conceptually simple model is a natural multivariate generalization of the accelerated failure time model, this article propose's an inference procedure by extending the weighted log-rank estimating function to the marked point process framework, The resulting estimators are consistent and asymptotically normal. In addition, robustness and efficiency issues are discussed. Furthermore, a novel sample-based variance estimation procedure is proposed for estimators based on nonsmooth estimating functions in general. Finally, simulation studies show that this proposal is reliable for practical use. An illustration with application to a lung cancer clinical trial is provided.