A sequential stratification method for estimating the effect of a time-dependent experimental treatment in observational studies.

A sequential stratification method for estimating the effect of a time-dependent experimental treatment in observational studies. Research Abstract Details 

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A sequential stratification method for estimating the effect of a time-dependent experimental treatment in observational studies. Abstract Text:

Douglas E Schaubel,Robert A Wolfe,Friedrich K Port,

Survival analysis is often used to compare experimental and conventional treatments. In observational studies, the therapy may change during follow-up and such crossovers can be summarized by time-dependent covariates. Given the ever-increasing donor organ shortage, higher-risk kidneys from expanded criterion donors (ECD) are being transplanted. Transplant candidates can choose whether to accept an ECD organ (experimental therapy), or to remain on dialysis and wait for a possible non-ECD transplant later (conventional therapy). A three-group time-dependent analysis of such data involves estimating parameters corresponding to two time-dependent indicator covariates representing ECD transplant and non-ECD transplant, each compared to remaining on dialysis on the waitlist. However, the ECD hazard ratio estimated by this time-dependent analysis fails to account for the fact that patients who forego an ECD transplant are not destined to remain on dialysis forever, but could subsequently receive a non-ECD transplant. We propose a novel method of estimating the survival benefit of ECD transplantation relative to conventional therapy (waitlist with possible subsequent non-ECD transplant). Compared to the time-dependent analysis, the proposed method more accurately characterizes the data structure and yields a more direct estimate of the relative outcome with an ECD transplant.

A sequential stratification method for estimating the effect of a time-dependent experimental treatment in observational studies. Publishing Authors By Initials

DE Schaubel,RA Wolfe,FK Port,

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A sequential stratification method for estimating the effect of a time-dependent experimental treatment in observational studies. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: Biometrics

VOLUME: 62

Page Numbers: 910-7

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ISSN: 0006-341X

DAY: 3

MONTH: Sep

YEAR: 2006

A sequential stratification method for estimating the effect of a time-dependent experimental treatment in observational studies. Information

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LANGUAGE: eng

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Grant and Affiliation Information for A sequential stratification method for estimating the effect of a time-dependent experimental treatment in observational studies.

AFFILIATION: Department of Biostatistics, University of Michigan, Ann Arbor, Michigan 48109-2029, USA. deschau@umich.edu

Country: United States

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MEDLINETA: Biometrics

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