Joint modelling of cause-specific hazard functions with cubic splines: an application to a large series of breast cancer patients
Joint modelling of cause-specific hazard functions with cubic splines: an application to a large series of breast cancer patients
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DOI：
10.1016/s0167-9473(02)00122-6
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发表时间：
2003-02-28
影响因子：
1.8
通讯作者：
Marubini, E
中科院分区：
文献类型：
--
作者：
Boracchi, P;Biganzoli, E;Marubini, E
治疗干预后出现几种复发的时间在肿瘤学中越来越受关注。通常，在乳腺癌患者中，临床关注的事件是乳腺内肿瘤复发和远处转移，当被认为是首次失败时，它们以竞争性方式起作用。评估临床和生物学变量对每个事件的不同影响可以提高对疾病过程和未来治疗目标的了解。一个简单的工具，联合平滑估计的原因特定的风险函数和连续协变量的影响已经开发。在具有泊松误差的广义线性模型的框架内，提出了一种基于分组随访时间和连续协变量的分段指数模型的扩展。插值的原因特定的危险是通过诉诸三次样条，这是分段多项式的简单实现与标准的统计软件，其灵活性和平滑度很容易控制的结的数量和约束多项式导数。该方法被应用于2233例乳腺癌患者接受保守手术治疗的数据集。它允许建模的时间依赖性和原因特定的影响，协变量的危险函数。(C)出版社：Elsevier Science B.V.
The time of appearance of several kinds of relapses after a therapeutic intervention is of increasing interest in oncology. Typically, in breast cancer patients, events of clinical interest are intra-breast tumor recurrences and distant metastases, which act in a competitive way when considered as first failure. The evaluation of differential effects of clinical and biological variables on each event can improve the knowledge on the course of the disease and the targeting of future therapy. A simple tool for the joint smoothed estimation of cause-specific hazards functions and continuous covariate effects has been developed. Within the framework of generalized linear models with Poisson error, an extension of the piecewise exponential model is proposed, based on grouping follow-up times and continuous covariates. Interpolation of cause-specific hazards is obtained by resorting to cubic splines, which are piecewise polynomials of simple implementation with standard statistical software; their flexibility and smoothness are easily controlled by the number of knots and constraints on polynomial derivatives. The approach was applied to a data set of 2233 breast cancer patients treated with conservative surgery. It allowed modelling time-dependent and cause-specific effects of covariates on the hazard functions. (C) 2002 Published by Elsevier Science B.V.