ijsmr
Abstract: Analysis of Recurrent Events with Associated Informative Censoring: Application to HIV Data
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Abstract: In this study, we adapt a Cox-based model for recurrent events; the Prentice, Williams and Peterson Total -Time (PWP-TT) that has largely, been used under the assumption of non-informative censoring and evaluate it under an informative censoring setting. Empirical evaluation was undertaken with the aid of the semi-parametric framework for recurrent events suggested by Huang [1] and implemented in R Studio software. For validation we used data from a typical HIV care setting in Kenya. Of the three models under consideration; the standard Cox Model had gender hazard ratio (HR) of 0.66 (p-value=0.165), Andersen-Gill had HR 0.46 (with borderline p-value=0.054) and extended PWP TT had HR 0.22 (p-value=0.006). The PWP-TT model performed better as compared to other models under informative setting. In terms of risk factors under informative setting, LTFU due to stigma; gender [base=Male] had HR 0.544 (p-value =0.002), age [base is < 37] had HR 0.772 (p-value=0.008), ART regimen [base= First line] had HR 0.518 (p-value= 0.233) and differentiated care model (Base=not on DCM) had HR 0.77(p-value=0.036). In conclusion, in spite of the multiple interventions designed to address incidences of LTFU among HIV patients, within-person cases of LTFU are usually common and recurrent in nature, with the present likelihood of a person getting LTFU influenced by previous occurrences and therefore informative censoring should be checked. Keywords: Recurrent events, Loss to follow-up, HIV, Prentice, Williams and Peterson Gap-Time, Informative censoring. |
Abstract: Survival Curves Projection and Benefit Time Points Estimation using a New Statistical Method
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Abstract: Survival analysis concerns the analysis of time-to-event data and it is essential to study in fields such as oncology, the survival function, S(t), calculation is usually used, but in the presence of competing risks (presence of competing events), is necessary introduce other statistical concepts and methods, as is the Cumulative incidence function CI(t). This is defined as the proportion of subjects with an event time less than or equal to. The present study describe a methodology that enables to obtain numerically a shape of CI(t) curves and estimate the benefit time points (BTP) as the time (t) when a 90, 95 or 99% is reached for the maximum value of CI(t). Once you get the numerical function of CI(t), it can be projected for an infinite time, with all the limitations that it entails. To do this task the R function Weibull.cumulative.incidence() is proposed. In a first step these function transforms the survival function (S(t)) obtained using the Kaplan–Meier method to CI(t). In a second step the best fit function of CI(t) is calculated in order to estimate BTP using two procedures, 1) Parametric function: estimates a Weibull growth curve of 4 parameters by means a non-linear regression (nls) procedure or 2) Non parametric method: using Local Polynomial Regression (LPR) or LOESS fitting. Two examples are presented and developed using Weibull.cumulative.incidence() function in order to present the method. The methodology presented will be useful for performing better tracking of the evolution of the diseases (especially in the case of the presence of competitive risks), project time to infinity and it is possible that this methodology can help identify the causes of current trends in diseases like cancer. We think that BTP points can be important in large diseases like cardiac illness or cancer to seek the inflection point of the disease, treatment associate or speculate how is the course of the disease and change the treatments at those points. These points can be important to take medical decisions furthermore. Keywords: Survival function, projection, Weibull growth curve, non linear regression. |
Abstract: Inference Procedures on the Ratio of Modified Generalized Poisson Distribution Means: Applications to RNA_SEQ Data
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Abstract: The Poisson and the Negative Binomial distributions are commonly used as analytic tools to model count data. The Poisson is characterized by the equality of mean and variance whereas the Negative Binomial has a variance larger than the mean and therefore is appropriate to model over-dispersed count data. The Generalized Poisson Distribution is becoming a popular alternative to the Negative Binomial. We have considered inference procedures on a modified form of this distribution when two samples are available from two independent populations and the target effect size of interest is the ratio of the two population means. The statistical objective is to construct confidence limits on the ratio. We first test the presence of over dispersion and derive several estimators in the single sample situation. When two samples are available, our interest is focused on the estimation of an effect size measured by the ratio of the respective population means. We have compared two methods; namely the Fieller’s and the delta methods in terms of coverage probabilities. We have illustrated the methodologies on published genomic datasets. Keywords: Overdispersion, Parameter orthogonality, Fieller’s theorem, Mixed estimator, Delta method, Coverage probabilities. |
Abstract: The Effect of the Health Personnel Exposed to the Attack of Patients and Relatives on the Perception of Aggression
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Abstract: Purpose: The aim of the study is to evaluate the effect of health personnel's exposure to the violence of patients and relatives on the perception of aggression. Keywords: Health Personnel, Exposure to Violence, Aggression, Perception. |
