论文标题

近端生存分析以处理依赖的右审查

Proximal Survival Analysis to Handle Dependent Right Censoring

论文作者

Ying, Andrew

论文摘要

许多流行病学和临床研究旨在分析事件时间的终点。一个常见的并发症是正确的检查。在某些情况下,它之所以出现,是因为在研究终止或搬出研究区域后仍在生存,在这种情况下,正确的审查通常被视为独立或非信息性。可以通过利用可能具有时变的协变量信息(如果有)在协变量层之间独立的情况下,可以将这种假设进一步放松到有条件的独立审查中。在其他情况下,可能会受到其他竞争事件(例如死亡)的审查,并且可能通过预后来审查。实际上,测得的协变量很少能确定地捕获所有这些关联。对于这种依赖的审查,通常协变量测量最多是潜在预后的代理。在本文中,我们通过正式承认有条件的独立审查可能在实践中失败并考虑协方差测量是基础关联的不完善代理,从而建立了一个非参数识别框架。该框架提出了自适应估计量,我们给出了它们一致,渐近正常且双重鲁棒的一般假设。我们通过具体设置说明了我们的框架,在该设置中,我们通过蒙特卡洛模拟检查了我们提出的估计器的有限样本性能,并将其应用于Seer-Medicare数据集。

Many epidemiological and clinical studies aim at analyzing a time-to-event endpoint. A common complication is right censoring. In some cases, it arises because subjects are still surviving after the study terminates or move out of the study area, in which case right censoring is typically treated as independent or non-informative. Such an assumption can be further relaxed to conditional independent censoring by leveraging possibly time-varying covariate information, if available, assuming censoring and failure time are independent among covariate strata. In yet other instances, events may be censored by other competing events like death and are associated with censoring possibly through prognoses. Realistically, measured covariates can rarely capture all such associations with certainty. For such dependent censoring, often covariate measurements are at best proxies of underlying prognoses. In this paper, we establish a nonparametric identification framework by formally admitting that conditional independent censoring may fail in practice and accounting for covariate measurements as imperfect proxies of underlying association. The framework suggests adaptive estimators which we give generic assumptions under which they are consistent, asymptotically normal, and doubly robust. We illustrate our framework with concrete settings, where we examine the finite-sample performance of our proposed estimators via a Monte-Carlo simulation and apply them to the SEER-Medicare dataset.

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