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在生存分析中使用联合建模和时间标记法对具有时间依存性协变量进行动态预测。

Dynamic predictions with time-dependent covariates in survival analysis using joint modeling and landmarking.

作者信息

Rizopoulos Dimitris, Molenberghs Geert, Lesaffre Emmanuel M E H

机构信息

Department of Biostatistics, Erasmus Medical Center, The Netherlands.

Interuniversity Institute for Biostatistics and Statistical Bioinformatics, KU Leuven & Universiteit Hasselt, Belgium.

出版信息

Biom J. 2017 Nov;59(6):1261-1276. doi: 10.1002/bimj.201600238. Epub 2017 Aug 9.

Abstract

A key question in clinical practice is accurate prediction of patient prognosis. To this end, nowadays, physicians have at their disposal a variety of tests and biomarkers to aid them in optimizing medical care. These tests are often performed on a regular basis in order to closely follow the progression of the disease. In this setting, it is of interest to optimally utilize the recorded information and provide medically relevant summary measures, such as survival probabilities, which will aid in decision making. In this work, we present and compare two statistical techniques that provide dynamically updated estimates of survival probabilities, namely landmark analysis and joint models for longitudinal and time-to-event data. Special attention is given to the functional form linking the longitudinal and event time processes, and to measures of discrimination and calibration in the context of dynamic prediction.

摘要

临床实践中的一个关键问题是对患者预后的准确预测。为此,如今医生可利用各种检测和生物标志物来辅助优化医疗护理。这些检测通常定期进行,以便密切跟踪疾病进展。在这种情况下,最优利用所记录的信息并提供具有医学相关性的汇总指标(如生存概率)以辅助决策,是很有意义的。在这项工作中,我们展示并比较了两种能提供动态更新的生存概率估计值的统计技术,即标志性分析以及针对纵向数据和事件发生时间数据的联合模型。我们特别关注连接纵向过程和事件时间过程的函数形式,以及动态预测背景下的区分度和校准度指标。

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