Comparison of methods to correct survival estimates and survival regression analysis on a large HIV African cohort.
Comparison of methods to correct survival estimates and survival regression analysis on a large HIV African cohort.
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DOI：
10.1371/journal.pone.0031706
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Ecochard R
中科院分区：
文献类型：
--
作者：
Henriques J;Pujades-Rodriguez M;McGuire M;Szumilin E;Iwaz J;Etard JF;Ecochard R
对艾滋病毒治疗方案的评估通常基于对接受抗逆转录病毒治疗（ART）的患者生存率的估计。在大型HIV项目中，尽管积极追踪患者，但失访（LFU）率仍然很高，这可能会使生存估计和生存回归分析产生偏差。我们比较了未经校正的生存估计来自常规程序的数据，估计通过应用六种校正方法，使用更新的结果数据，在马拉维农村艾滋病毒项目的LFU患者的实地调查。这些方法基于双重抽样，并根据LFU和非LFU亚群中生存估计值的权重而有所不同。然后，我们提出了生存回归分析的校正。在接受抗逆转录病毒治疗的6，727名艾滋病毒感染成人中，9%在一年后成为LFU。根据常规数据，未校正的生存率估计值在女性中为91%，男性为84%。随着校正方法的日益复杂，女性校正后的生存率估计值为89%至85%，男性为82%至77%。未经校正的回归分析得出的估计值对初始结核病死亡率有很大的偏差（RR; 95% CI：1.07; 0.76-1.50 vs. 2.06 - 2.28，不同校正权重），卡波西肉瘤诊断（2.11; 1.61-2.76 vs. 2.64 - 3.9）和开始抗逆转录病毒治疗的年份（1.40; 1.17-1.66 vs. 1.29 - 1.34）。在具有高LFU率的HIV项目中，使用基于非穷举双采样数据的校正方法是必要的，以最大限度地减少生存估计和生存回归的偏倚。
The evaluation of HIV treatment programs is generally based on an estimation of survival among patients receiving antiretroviral treatment (ART). In large HIV programs, loss to follow-up (LFU) rates remain high despite active patient tracing, which is likely to bias survival estimates and survival regression analyses. We compared uncorrected survival estimates derived from routine program data with estimates obtained by applying six correction methods that use updated outcome data by a field survey targeting LFU patients in a rural HIV program in Malawi. These methods were based on double-sampling and differed according to the weights given to survival estimates in LFU and non-LFU subpopulations. We then proposed a correction of the survival regression analysis. Among 6,727 HIV-infected adults receiving ART, 9% were LFU after one year. The uncorrected survival estimates from routine data were 91% in women and 84% in men. According to increasing sophistication of the correction methods, the corrected survival estimates ranged from 89% to 85% in women and 82% to 77% in men. The estimates derived from uncorrected regression analyses were highly biased for initial tuberculosis mortality ratios (RR; 95% CI: 1.07; 0.76–1.50 vs. 2.06 to 2.28 with different correction weights), Kaposi sarcoma diagnosis (2.11; 1.61–2.76 vs. 2.64 to 3.9), and year of ART initiation (1.40; 1.17–1.66 vs. 1.29 to 1.34). In HIV programs with high LFU rates, the use of correction methods based on non-exhaustive double-sampling data are necessary to minimise the bias in survival estimates and survival regressions.
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影响因子：
3
作者：
Lanoy, E.;Lewden, C.;Costagliola, D.
通讯作者：
Costagliola, D.
DOI：
10.1111/j.1365-3156.2010.02507.x
发表时间：
2010-06
期刊：
Tropical medicine & international health : TM & IH
影响因子：
--
作者：
Geng EH;Glidden DV;Emenyonu N;Musinguzi N;Bwana MB;Neilands TB;Muyindike W;Yiannoutsos CT;Deeks SG;Bangsberg DR;Martin JN
通讯作者：
Martin JN
DOI：
10.1111/j.1365-3156.2010.02473.x
发表时间：
2010-04
期刊：
Tropical medicine & international health : TM & IH
影响因子：
--
作者：
Fox MP;Brennan A;Maskew M;MacPhail P;Sanne I
通讯作者：
Sanne I
影响因子：
1.9
作者：
Frangakis, CE;Rubin, DB
通讯作者：
Rubin, DB
影响因子：
3.7
作者：
COOK, JR;STEFANSKI, LA
通讯作者：
STEFANSKI, LA