Yee Laura M, Chan Kwun Chuen Gary
Center for Devices and Radiological Health, U.S. Food and Drug Administration, 10903 New Hampshire Ave, Silver Spring, MD, 20993, USA.
Department of Biostatistics, University of Washington, Campus Box 357232, Seattle, WA, 98195-7232, USA.
Lifetime Data Anal. 2017 Apr;23(2):207-222. doi: 10.1007/s10985-015-9347-7. Epub 2015 Sep 30.
Time between recurrent medical events may be correlated with the cost incurred at each event. As a result, it may be of interest to describe the relationship between recurrent events and recurrent medical costs by estimating a joint distribution. In this paper, we propose a nonparametric estimator for the joint distribution of recurrent events and recurrent medical costs in right-censored data. We also derive the asymptotic variance of our estimator, a test for equality of recurrent marker distributions, and present simulation studies to demonstrate the performance of our point and variance estimators. Our estimator is shown to perform well for a wide range of levels of correlation, demonstrating that our estimators can be employed in a variety of situations when the correlation structure may be unknown in advance. We apply our methods to hospitalization events and their corresponding costs in the second Multicenter Automatic Defibrillator Implantation Trial (MADIT-II), which was a randomized clinical trial studying the effect of implantable cardioverter-defibrillators in preventing ventricular arrhythmia.
复发性医疗事件之间的时间间隔可能与每次事件产生的费用相关。因此，通过估计联合分布来描述复发性事件与复发性医疗费用之间的关系可能会很有意义。在本文中，我们针对右删失数据中复发性事件和复发性医疗费用的联合分布提出了一种非参数估计方法。我们还推导了估计量的渐近方差、复发性标记分布相等性的检验方法，并进行了模拟研究以展示我们的点估计量和方差估计量的性能。结果表明，我们的估计量在广泛的相关水平范围内表现良好，这表明当相关结构可能事先未知时，我们的估计量可用于多种情况。我们将我们的方法应用于第二次多中心自动除颤器植入试验（MADIT-II）中的住院事件及其相应费用，该试验是一项研究植入式心脏复律除颤器预防室性心律失常效果的随机临床试验。
