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Full-Text Articles in Physical Sciences and Mathematics

Marginal Structural Models: An Application To Incarceration And Marriage During Young Adulthood, Valerio Bacak, Edward Kennedy Jan 2015

Marginal Structural Models: An Application To Incarceration And Marriage During Young Adulthood, Valerio Bacak, Edward Kennedy

Edward H. Kennedy

Advanced methods for panel data analysis are commonly used in research on family life and relationships, but the fundamental issue of simultaneous time-dependent confounding and mediation has received little attention. In this article the authors introduce inverse-probability-weighted estimation of marginal structural models, an approach to causal analysis that (unlike conventional regression modeling) appropriately adjusts for confounding variables on the causal pathway linking the treatment with the outcome. They discuss the need for marginal structural models in social science research and describe their estimation in detail. Substantively, the authors contribute to the ongoing debate on the effects of incarceration on marriage …


Comparison Of Methods For Estimating The Effect Of Salvage Therapy In Prostate Cancer When Treatment Is Given By Indication., Jeremy Taylor, Jincheng Shen, Edward Kennedy, Lu Wang, Douglas Schaubel Dec 2013

Comparison Of Methods For Estimating The Effect Of Salvage Therapy In Prostate Cancer When Treatment Is Given By Indication., Jeremy Taylor, Jincheng Shen, Edward Kennedy, Lu Wang, Douglas Schaubel

Edward H. Kennedy

For patients who were previously treated for prostate cancer, salvage hormone therapy is frequently given when the longitudinal marker prostate-specific antigen begins to rise during follow-up. Because the treatment is given by indication, estimating the effect of the hormone therapy is challenging. In a previous paper we described two methods for estimating the treatment effect, called two-stage and sequential stratification. The two-stage method involved modeling the longitudinal and survival data. The sequential stratification method involves contrasts within matched sets of people, where each matched set includes people who did and did not receive hormone therapy. In this paper, we evaluate …


Instrumental Variable Analyses: Exploiting Natural Randomness To Understand Causal Mechanisms, Theodore Iwashyna, Edward Kennedy Dec 2012

Instrumental Variable Analyses: Exploiting Natural Randomness To Understand Causal Mechanisms, Theodore Iwashyna, Edward Kennedy

Edward H. Kennedy

Instrumental variable analysis is a technique commonly used in the social sciences to provide evidence that a treatment causes an outcome, as contrasted with evidence that a treatment is merely associated with differences in an outcome. To extract such strong evidence from observational data, instrumental variable analysis exploits situations where some degree of randomness affects how patients are selected for a treatment. An instrumental variable is a characteristic of the world that leads some people to be more likely to get the specific treatment we want to study but does not otherwise change thosepatients’ outcomes. This seminar explains, in nonmathematical …


Improved Cardiovascular Risk Prediction Using Nonparametric Regression And Electronic Health Record Data, Edward Kennedy, Wyndy Wiitala, Rodney Hayward, Jeremy Sussman Dec 2012

Improved Cardiovascular Risk Prediction Using Nonparametric Regression And Electronic Health Record Data, Edward Kennedy, Wyndy Wiitala, Rodney Hayward, Jeremy Sussman

Edward H. Kennedy

Use of the electronic health record (EHR) is expected to increase rapidly in the near future, yet little research exists on whether analyzing internal EHR data using flexible, adaptive statistical methods could improve clinical risk prediction. Extensive implementation of EHR in the Veterans Health Administration provides an opportunity for exploration. Our objective was to compare the performance of various approaches for predicting risk of cerebrovascular and cardiovascular (CCV) death, using traditional risk predictors versus more comprehensive EHR data. Regression methods outperformed the Framingham risk score, even with the same predictors (AUC increased from 71% to 73% and calibration also improved). …


The Effect Of Salvage Therapy On Survival In A Longitudinal Study With Treatment By Indication, Edward Kennedy, Jeremy Taylor, Douglas Schaubel, Scott Williams Dec 2009

The Effect Of Salvage Therapy On Survival In A Longitudinal Study With Treatment By Indication, Edward Kennedy, Jeremy Taylor, Douglas Schaubel, Scott Williams

Edward H. Kennedy

We consider using observational data to estimate the effect of a treatment on disease recurrence, when the decision to initiate treatment is based on longitudinal factors associated with the risk of recurrence. The effect of salvage androgen deprivation therapy (SADT) on the risk of recurrence of prostate cancer is inadequately described by the existing literature. Furthermore, standard Cox regression yields biased estimates of the effect of SADT, since it is necessary to adjust for prostate-specific antigen (PSA), which is a time-dependent confounder and an intermediate variable. In this paper, we describe and compare two methods which appropriately adjust for PSA …