A Generalized Model for Post-transplant Survival

描述（由申请人提供） 申请人的长期职业目标是成为一名独立调查员 临床和卫生服务研究的分析方法。她将 致力于进行定量研究和促进适当的 在这些研究领域使用分析方法。这个职业 发展奖将为她提供初步支持，以实现她的目标。 职业目标。 未来五年，她的职业发展有三个目标。 首先，她将开发一个通用的生存回归模型， 比目前使用的任何半参数回归模型都要全面 肝移植数据的分析。拟议的研究将 导致限制性较少的假设，并提供一种系统的方法， 建立肝移植研究中的生存模型。的产品 该研究包括一个新模型，可用于估计 移植后存活率，这反过来又可以用来估计最佳的 肝移植的时机她的第二个目标是发展专业知识 生存分析的临床应用，以患者为导向的研究。 第三个目标是成为临床研究人员的教育者， 方法论。 虽然在移植领域，许多其他问题也很重要， (such哪种器官分配方法是最佳的， 时间列出一个病人的移植），许多临床相关的 问题需要准确和临床相关的生存预测。的 拟议的研究将侧重于： 目的1：建立一个通用的生存回归模型。 目标2：开发一般生存回归的诊断程序 模型 目的3：评估不同生存模式对预后的影响 肝脏移植的研究 提出的一般生存模型可简化为可加性和 乘法模型作为特例。此外，协变量对风险的影响 在这个模型中可以是恒定的或随时间变化的。估计模型 参数将通过惩罚对数偏似然与双 处罚条款对任何给定协变量的影响的推断也将是 评估。

DESCRIPTION (provided by applicant) The applicant's long-term career goal is to become an independent investigator in analytical methodologies for clinical and health services research. She will dedicate her career to conducting quantitative studies and promoting the proper use of analytical methodologies in these research areas. This career development award will provide her with initial support for achieving her career goals. There are three goals for her career development over the next five years. First, she will develop a general survival regression model that is more encompassing than any of the semi-parametric regression models currently used in the analysis of liver transplantation data. The proposed research will result in less restrictive assumptions and provide a systematic way of constructing survival models in liver transplantation studies. The products of the research include a new model that can be used to provide estimates on post-transplant survival, which in turn can be used to estimate the optimal timing for liver transplantation. Her second objective is to develop expertise in clinical applications of survival analysis for patient-oriented research. The third goal is to become an educator to clinical researchers in analytical methodologies. While many other questions are also important in the area of transplantation (such as which organ allocation method is optimal and what is the appropriate time to list a patient for transplant), many of the clinically related questions require accurate and clinically relevant predictions of survival. The proposed research will focus on: Aim 1: Development of a general survival regression model. Aim 2: Development of diagnostic procedures for the general survival regression model. Aim 3: Assessment of the impact of different survival models on the prognosis in liver transplantation. The proposed general survival model that reduces to both the additive and multiplicative model as special cases. Moreover, the covariate effect on hazard in this model can be either constant or time-varying. Estimation of the model parameters will through the penalized log-partial likelihood with double penalty terms. Inference on the effect of any given covariate will also be assessed.