Physical Sciences and Mathematics Commons^™

Comparing The Cohort Design And The Nested Case-Control Design In The Presence Of Both Time-Invariant And Time-Dependent Treatment And Competing Risks: Bias And Precision, Peter C. Austin

Peter Austin

Purpose: Observational studies using electronic administrative health care databases are often used to estimate the effects of treatments and exposures. Traditionally, a cohort design has been used to estimate these effects, but increasingly studies are using a nested case-control (NCC) design. The relative statistical efficiency of these two designs has not been examined in detail.

Methods: We used Monte Carlo simulations to compare these two designs in terms of the bias and precision of effect estimates. We examined three different settings: (A): treatment occurred at baseline and there was a single outcome of interest; (B): treatment was time-varying and there …

Using Ensemble-Based Methods For Directly Estimating Causal Effects: An Investigation Of Tree-Based G-Computation, Peter C. Austin

Peter Austin

Researchers are increasingly using observational or nonrandomized data to estimate causal treatment effects. Essential to the production of high-quality evidence is the ability to reduce or minimize the confounding that frequently occurs in observational studies. When using the potential outcome framework to define causal treatment effects, one requires the potential outcome under each possible treatment. However, only the outcome under the actual treatment received is observed, whereas the potential outcomes under the other treatments are considered missing data. Some authors have proposed that parametric regression models be used to estimate potential outcomes. In this study, we examined the use of …

Regression Trees For Predicting Mortality In Patients With Cardiovascular Disease: What Improvement Is Achieved By Using Ensemble-Based Methods?, Peter C. Austin

Peter Austin

In biomedical research, the logistic regression model is the most commonly used method for predicting the probability of a binary outcome. While many clinical researchers have expressed an enthusiasm for regression trees, this method may have limited accuracy for predicting health outcomes. We aimed to evaluate the improvement that is achieved by using ensemble-based methods, including bootstrap aggregation (bagging) of regression trees, random forests, and boosted regression trees. We analyzed 30-day mortality in two large cohorts of patients hospitalized with either acute myocardial infarction (N = 16,230) or congestive heart failure (N = 15,848) in two distinct eras (1991-2001 and …

Generating Survival Times To Simulate Cox Proportional Hazards Models With Time-Varying Covariates., Peter C. Austin

Peter Austin

Simulations and Monte Carlo methods serve an important role in modern statistical research. They allow for an examination of the performance of statistical procedures in settings in which analytic and mathematical derivations may not be feasible. A key element in any statistical simulation is the existence of an appropriate data-generating process: one must be able to simulate data from a specified statistical model. We describe data-generating processes for the Cox proportional hazards model with time-varying covariates when event times follow an exponential, Weibull, or Gompertz distribution. We consider three types of time-varying covariates: first, a dichotomous time-varying covariate that can …