Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Stat Med. 2011 Mar 15;30(6):654-65. doi: 10.1002/sim.4123. Epub 2010 Nov 30.
In the analysis of survival data, there are often competing events that preclude an event of interest from occurring. Regression analysis with competing risks is typically undertaken using a cause-specific proportional hazards model. However, modern alternative methods exist for the analysis of the subdistribution hazard with a corresponding subdistribution proportional hazards model. In this paper, we introduce a flexible parametric mixture model as a unifying method to obtain estimates of the cause-specific and subdistribution hazards and hazard-ratio functions. We describe how these estimates can be summarized over time to give a single number comparable to the hazard ratio that is obtained from a corresponding cause-specific or subdistribution proportional hazards model. An application to the Women's Interagency HIV Study is provided to investigate injection drug use and the time to either the initiation of effective antiretroviral therapy, or clinical disease progression as a competing event.
在生存数据分析中，常常存在竞争事件，使得感兴趣的事件无法发生。使用竞争风险的回归分析通常采用特定原因的比例风险模型进行。然而，现代替代方法存在于亚分布风险的分析中，对应亚分布比例风险模型。在本文中，我们引入了一种灵活的参数混合模型，作为一种统一的方法来获得特定原因和亚分布风险和风险比函数的估计值。我们描述了如何随着时间的推移对这些估计值进行总结，以给出一个与从相应特定原因或亚分布比例风险模型获得的风险比相当的单一数字。对妇女艾滋病联合机构研究的应用，旨在研究注射吸毒以及开始有效抗逆转录病毒治疗或临床疾病进展作为竞争事件的时间。
