A general multilevel multistate competing risks model for event history data, with an application to a study of contraceptive use dynamics
A general multilevel multistate competing risks model for event history data, with an application to a study of contraceptive use dynamics
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DOI：
10.1191/1471082x04st069oa
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发表时间：
2004-07-01
影响因子：
1
通讯作者：
Browne, W
中科院分区：
文献类型：
--
作者：
Steele, F;Goldstein, H;Browne, W
我们提出了一个多水平事件历史数据的通用离散时间模型。该模型是为分析个人内部的纵向重复发作而开发的，其中存在多个状态和多种类型的事件(竞争风险)，这些事件可能因州而异。不同的转变被联合建模，以允许在未观察到的个人风险因素中的转变之间存在相关性。描述了使用离散响应数据的现有多水平模型的方法的实施。该模型被应用于印度尼西亚避孕用具使用动态的分析，其中从使用避孕用具和不使用避孕用具这两个状态的转变是有意义的。一次避孕用法结束的两种方式是不同的：转变为不使用或改用另一种方法。在调整协变量效应之前，从使用到不使用和从不使用到使用的风险之间存在着很强的负残差相关性；这种相关性是由于一种趋势，即出生后短期不使用，随后长期使用相同的避孕方法。
We propose a general discrete time model for multilevel event history data. The model is developed for the analysis of longitudinal repeated episodes within individuals where there are multiple states and multiple types of event (competing risks) which may vary across states. The different transitions are modelled jointly to allow for correlation across transitions in unobserved individual risk factors. Implementation of the methodology using existing multilevel models for discrete response data is described. The model is applied in an analysis of contraceptive use dynamics in Indonesia where transitions from two states, contraceptive use and nonuse, are of interest. A distinction is made between two ways in which an episode of contraceptive use may end: a transition to nonuse or a switch to another method. Before adjusting for covariate effects, there is a strong negative residual correlation between the hazards of a transition from use to nonuse and from nonuse to use; this correlation is due to a tendency for short periods of nonuse after a birth to be followed by long periods of using the same contraceptive method.