Statistical Methods of Cardiotoxicity Studies in Aids

艾滋病心脏毒性研究的统计方法

• 批准号: 7169229
• 负责人: Stuart R. Lipsitz
• 金额: $ 25.26万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-12-01 至 2008-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7169229
• 关键词: Accounting; Acquired Immunodeficiency Syndrome; Age; Blood Pressure; Cardiac; Cardiac Function Study; Cardiotoxicity; Cardiovascular Abnormalities; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Child; Childhood; Clinic Visits; Condition; Congenital Heart Defects; Data; Data Analyses; Detection; Development; Diagnosis; Diagnostic; Dimensions; Disease Progression; Disease regression; Dropout; Drops; Echocardiography; Event; Gender; Goals; Grant; HIV; HIV Infections; HIV diagnosis; HIV-1; Health; Heart Diseases; Heart Function Tests; Heart Rate; Heart failure; Individual; Infection; Left Ventricular Mass; Longitudinal Studies; Lung; Measurement; Measures; Methodology; Methods; Modeling; Monitor; Morbidity - disease rate; Multivariate Analysis; Opportunistic Infections; Outcome; Patients; Pattern; Physicians; Principal Investigator; Probability; Process; Rate; Recording of previous events; Research; Research Design; Risk; Statistical Methods; Statistical Models; Symptoms; Thick; Time; Virus; Visit; Woman; Zidovudine; base; design; follow-up; heart function; improved; interest; method development; migration; mortality; programs; prospective; sarcoma; simulation; treatment effect

DESCRIPTION (provided by applicant): Data from longitudinal studies have suggested that patients infected with HIV-1 might have cardiovascular abnormalities. These abnormalities may be the result of the treatments (AZT, etc.) or the HIV-1 virus itself. In this grant, we will develop methods to analyze longitudinal and survival studies of heart function in AIDS patients. Cardiotoxicity in AIDS patients could be a leading cause of morbidity and mortality. Development of methods leading to increased understanding of the cardiotoxicity could prove invaluable in determining the appropriate time to give cardioprotective therapies. The developed methods will be applied to the Pediatric Pulmonary and Cardiac Complications (P2C2) of Vertically Transmitted HIV Infection Study, which was a large, prospective longitudinal study designed to monitor heart disease and the progression of cardiac abnormalities in children born to HIV-infected women. To truly understand the change in heart function over time, new models and methods need to be developed that take into account multiple measures of heart function (LV mass, end-diastolic dimension, end-systolic dimension, fractional shortening, etc.). The models and associated statistical methods should be such that biases do not result because of higher rates of clinic visits by sicker patients, higher chance of dropout for sicker patients, missed clinic visits due to patients' health conditions, etc. In this grant, we develop appropriate models and methods to deal with these situations. We will examine the following six Specific Aims. Regression models for Longitudinal Discrete and Continuous Outcomes; A likelihood method for Longitudinal Studies with Informative Dropout; A Protective Estimator for Mixed Discrete and Continuous Outcomes Subject to Nonignorable Non-monotone Missingness; Methods for Estimation in Longitudinal Studies with Outcome-Dependent Follow-Up; and Prediction in Multivariate Survival Models; Sensitivity Analysis for the previous six aims.

描述（由申请人提供）：纵向研究的数据表明，感染HIV-1的患者可能有心血管异常。这些异常可能是治疗（AZT等）的结果。或者HIV-1病毒本身。 在这项资助中，我们将开发方法来分析艾滋病患者心脏功能的纵向和生存研究。艾滋病患者的药物毒性可能是发病率和死亡率的主要原因。开发导致增加对心脏毒性的理解的方法可以证明在确定给予心脏保护治疗的适当时间方面是非常宝贵的。开发的方法将应用于垂直传播HIV感染研究的儿科肺和心脏并发症（P2 C2），这是一项大型前瞻性纵向研究，旨在监测HIV感染妇女所生儿童的心脏疾病和心脏异常进展。为了真正了解心脏功能随时间的变化，需要开发新的模型和方法，这些模型和方法考虑到心脏功能的多种测量（LV质量、舒张末期尺寸、收缩末期尺寸、缩短分数等）。模型和相关的统计方法应该是这样的偏差不会导致，因为较高的患病率的病人，较高的机会辍学的病人，错过了诊所就诊，由于病人的健康状况等，在这个补助金，我们开发适当的模型和方法来处理这些情况。我们将研究以下六个具体目标。纵向离散和连续结局的回归模型;信息性脱落的纵向研究的似然方法;非单调缺失的混合离散和连续结局的保护性估计;结果依赖随访的纵向研究中的估计方法;多变量生存模型的预测;前六个目标的敏感性分析。