Biostatistics Commons^™

On Causal Mediation Analysis With A Survival Outcome, Eric J. Tchetgen Tchetgen

Harvard University Biostatistics Working Paper Series

Suppose that having established a marginal total effect of a point exposure on a time-to-event outcome, an investigator wishes to decompose this effect into its direct and indirect pathways, also know as natural direct and indirect effects, mediated by a variable known to occur after the exposure and prior to the outcome. This paper proposes a theory of estimation of natural direct and indirect effects in two important semiparametric models for a failure time outcome. The underlying survival model for the marginal total effect and thus for the direct and indirect effects, can either be a marginal structural Cox proportional …

Semiparametric Estimation Of Models For Natural Direct And Indirect Effects, Eric J. Tchetgen Tchetgen, Ilya Shpitser

Harvard University Biostatistics Working Paper Series

In recent years, researchers in the health and social sciences have become increasingly interested in mediation analysis. Specifically, upon establishing a non-null total effect of an exposure, investigators routinely wish to make inferences about the direct (indirect) pathway of the effect of the exposure not through (through) a mediator variable that occurs subsequently to the exposure and prior to the outcome. Natural direct and indirect effects are of particular interest as they generally combine to produce the total effect of the exposure and therefore provide insight on the mechanism by which it operates to produce the outcome. A semiparametric theory …

Semiparametric Theory For Causal Mediation Analysis: Efficiency Bounds, Multiple Robustness, And Sensitivity Analysis, Eric J. Tchetgen Tchetgen, Ilya Shpitser

Harvard University Biostatistics Working Paper Series

Whilst estimation of the marginal (total) causal effect of a point exposure on an outcome is arguably the most common objective of experimental and observational studies in the health and social sciences, in recent years, investigators have also become increasingly interested in mediation analysis. Specifically, upon establishing a non-null total effect of the exposure, investigators routinely wish to make inferences about the direct (indirect) pathway of the effect of the exposure not through (through) a mediator variable that occurs subsequently to the exposure and prior to the outcome. Although powerful semiparametric methodologies have been developed to analyze observational studies, that …

Relationship Of Vitamin D Levels To Blood Pressure In A Biethnic Cohort, Rosario O. Sakamoto

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Serum hydroxyvitamin D [25(OH)D] has been well-accepted as not an ordinary vitamin but a pro-hormone that has many benefits beyond its well-known effects on bone. Cardiovascular risk factors such as hypertension remain a huge health burden and Blacks have been recognized to have higher prevalence of hypertension compared to non-Hispanic Whites. Despite increasing evidence of the benefits of vitamin D on blood pressure control, there is much more to be learned about the relationship of serum 25(OH)D to blood pressure among different ethnicities.

Purpose: The goal of this study was to determine whether vitamin D serum 25(OH)D levels were …

Ranking Single Nucleotide Polymorphisms With Support Vector Regression In Continuous Phenotypes, Seif Shahidain

Theses

Support vector machines (SVM) have been used to improve the ranking of single nucleotide polymorphisms (SNPs) over traditional chi-square tests in disease case studies [2]. In this investigation, ranking SNPs with support vector regression (SVR) was compared to the Wald test in predicting continuous phenotypes. SVR-ranked SNPs consistently outperformed the Wald test-ranked SNPs to provide a more accurate prediction of the phenotype with fewer SNPs across several methods of prediction.

A General Implementation Of Tmle For Longitudinal Data Applied To Causal Inference In Survival Analysis, Ori M. Stitelman, Victor De Gruttola, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

In many randomized controlled trials the outcome of interest is a time to event, and one measures on each subject baseline covariates and time-dependent covariates until the subject either drops-out, the time to event is observed, or the end of study is reached. The goal of such a study is to assess the causal effect of the treatment on the survival curve. Standard methods (e.g., Kaplan-Meier estimator, Cox-proportional hazards) ignore the available baseline and time-dependent covariates, and are therefore biased if the drop-out is affected by these covariates, and are always inefficient. We present a targeted maximum likelihood estimator of …

Targeted Minimum Loss Based Estimator That Outperforms A Given Estimator, Susan Gruber, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

Targeted minimum loss based estimation (TMLE) provides a template for the construction of semiparametric locally efficient double robust substitution estimators of the target parameter of the data generating distribution in a semiparametric censored data or causal inference model (van der Laan and Rubin (2006),van der Laan (2008), van der Laan and Rose (2011)). In this article we demonstrate how to construct a TMLE that also satisfies the property that it is at least as efficient as a user supplied asymptotically linear estimator. For the sake of illustration we focus on estimation of the additive average causal effect of a point …

The Relative Performance Of Targeted Maximum Likelihood Estimators, Kristin E. Porter, Susan Gruber, Mark J. Van Der Laan, Jasjeet S. Sekhon

U.C. Berkeley Division of Biostatistics Working Paper Series

There is an active debate in the literature on censored data about the relative performance of model based maximum likelihood estimators, IPCW-estimators, and a variety of double robust semiparametric efficient estimators. Kang and Schafer (2007) demonstrate the fragility of double robust and IPCW-estimators in a simulation study with positivity violations. They focus on a simple missing data problem with covariates where one desires to estimate the mean of an outcome that is subject to missingness. Responses by Robins et al. (2007), Tsiatis and Davidian (2007), Tan (2007a) and Ridgeway and McCaffrey (2007) further explore the challenges faced by double robust …

Estimation And Testing In Targeted Group Sequential Covariate-Adjusted Randomized Clinical Trials, Antoine Chambaz, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

This article is devoted to the construction and asymptotic study of adaptive group sequential covariate-adjusted randomized clinical trials analyzed through the prism of the semiparametric methodology of targeted maximum likelihood estimation (TMLE). We show how to build, as the data accrue group-sequentially, a sampling design which targets a user-supplied optimal design. We also show how to carry out a sound TMLE statistical inference based on such an adaptive sampling scheme (therefore extending some results known in the i.i.d setting only so far), and how group-sequential testing applies on top of it. The procedure is robust (i.e., consistent even if the …

Subsample Ignorable Likelihood For Accelerated Failure Time Models With Missing Predictors, Nanhua Zhang, Roderick J. Little

The University of Michigan Department of Biostatistics Working Paper Series

No abstract provided.

Threshold Regression Models Adapted To Case-Control Studies, And The Risk Of Lung Cancer Due To Occupational Exposure To Asbestos In France, Antoine Chambaz, Dominique Choudat, Catherine Huber, Jean-Claude Pairon, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

Asbestos has been known for many years as a powerful carcinogen. Our purpose is quantify the relationship between an occupational exposure to asbestos and an increase of the risk of lung cancer. Furthermore, we wish to tackle the very delicate question of the evaluation, in subjects suffering from a lung cancer, of how much the amount of exposure to asbestos explains the occurrence of the cancer. For this purpose, we rely on a recent French case-control study. We build a large collection of threshold regression models, data-adaptively select a better model in it by multi-fold likelihood-based cross-validation, then fit the …

Efektivitas Dan Efisiensi Sistem Informasi Keluarga Berencana Di Puskesmas, Aragar Putri, Besral Besral

Kesmas

Efisiensi dan efektivitas sistem informasi keluarga berencana (KB)-kesehatan yang telah disosialisasikan sejak tahun 2007 dibandingkan dengan sistem yang lama belum diketahui. Suatu penelitian survei dilakukan di empat provinsi, yaitu DKI Jakarta, Lampung, Kalimatan Tengah, dan Bali. Di tiap provinsi dipilih dua kabupaten/kota dan pada tiap kabupaten/kota dipilih dua puskesmas (kecamatan) yang sudah menerapkan sistem informasi KB-kesehatan tersebut. Pengumpulan data dilakukan pada bulan Juni-September 2008. Penelitian ini menemukan bahwa efektivitas dan efisiensi sistem informasi KB yang baru cukup baik, 77,8% responden menyatakan lebih efektif atau sangat lebih efektif dan 66,7% responden menyatakan lebih efisien atau sangat lebih efisien dibandingkan dengan sistem …

Bate Curve In Assessment Of Clinical Utility Of Predictive Biomarkers, Xiao-Hua Zhou, Yunbei Ma

UW Biostatistics Working Paper Series

In this paper, for time-to-event data, we propose a new statistical framework for casual inference in evaluating clinical utility of predictive biomarkers and in selecting an optimal treatment for a particular patient. This new casual framework is based on a new concept, called Biomarker Adjusted Treatment Effect (BATE) curve, which can be used to represent the clinical utility of a predictive biomarker and select an optimal treatment for one particular patient. We then propose semi-parametric methods for estimating the BATE curves of biomarkers and establish asymptotic results of the proposed estimators for the BATE curves. We also conduct extensive simulation …

Tmle: An R Package For Targeted Maximum Likelihood Estimation, Susan Gruber, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

Targeted maximum likelihood estimation (TMLE) presents an approach for construction of an efficient double-robust semi-parametric substitution estimator of a target feature of the data generating distribution, such as a statistical association measure or a causal effect parameter. tmle is a recently developed R package that implements TMLE for estimation of the effect of a binary treatment at a single point in time on an outcome of interest, controlling for user supplied covariates: the additive treatment effect, the relative risk, the odds ratio. The package allows outcome data with missingness, and experimental units that contribute repeated records of the point-treatment data …

Causal Inference Under Multiple Versions Of Treatment, Tyler J. Vanderweele, Miguel A. Hernan

COBRA Preprint Series

In this article we discuss the no-multiple-versions-of-treatment assumption and extend the potential outcomes framework to accommodate causal inference under violations of this assumption. A variety of examples are discussed in which the assumption may be violated. Identification results are provided for the overall treatment effect and the effect of treatment on the treated when multiple versions of treatment are present and also for the causal effect comparing a version of one treatment to some other version of the same or a different treatment. Further identification and interpretative results are given for cases in which a treatment variable is dichotomized to …

Non-Homogeneous Markov Process Models With Incomplete Observations: Application To A Dementia Disease Study, Xiao-Hua Zhou, Baojiang Chen

UW Biostatistics Working Paper Series

Identifying risk factors for transition rates among normal cognition, mildly cognitive impairment, dementia and death in an Alzheimer's disease study is very important. It is known that transition rates among these states are strongly time dependent. While Markov process models are often used to describe these disease progressions, the literature mainly focuses on time homogeneous processes, and limited tools are available for dealing with non-homogeneity. Further, patients may choose when they want to visit the clinics, which creates informative observations. In this paper, we develop methods to deal with non-homogeneous Markov processes through time scale transformation when observation times are …

Doubly Robust Estimates For Binary Longitudinal Data Analysis With Missing Response And Missing Covariates, Baojiang Chen, Xiao-Hua Zhou

UW Biostatistics Working Paper Series

Longitudinal studies often feature incomplete response and covariate data. Likelihood-based methods such as the EM algorithm give consistent estimators for model parameters when data are missing at random provided that the response model and the missing covariate model are correctly specified; but we do not need to specify the missing data mechanism. An alternative method is the weighted estimating equation which gives consistent estimators if the missing data and response models are correctly specified; but we do not need to specify the distribution of the covariates that have missing values. In this paper we develop a doubly robust estimation method …

Semiparametric Estimation Of The Covariate-Specific Roc Curve In Presence Of Ignorable Verification Bias, Danping Liu, Xiao-Hua Zhou

UW Biostatistics Working Paper Series

Covariate-specific ROC curves are often used to evaluate the classification accuracy of a medical diagnostic test or a biomarker, when the accuracy of the test is associated with certain covariates. In many large-scale screening tests, the gold standard is subject to missingness due to high cost or harmfulness to the patient. In this paper, we propose a semiparametric estimation method for the covariate-specific ROC curves with a partial missing gold standard. A location-scale model is constructed for the test result to model the covariates' effect, but the residual distributions are left unspecified. Thus the baseline and link functions of the …

Evaluating Markers For Treatment Selection Based On Survival Time, Xiao Song, Xiao-Hua Zhou

UW Biostatistics Working Paper Series

For many medical conditions there are several treatment options available to patients. We consider evaluating markers based on a simple treatment selection policy that incorporates information on the patient's marker value exceeding a threshold. Although traditional regression methods may assess the effect of the marker and treatment on outcomes, it is appealing to quantify more directly the potential impact on the population of using the marker to select treatment. A useful tool is the selection impact (SI) curve proposed by Song and Pepe (2004, \textit{Biometrics} \textbf{60}, 874--883) for binary outcomes. However, this approach does not deal with continuous outcomes, nor …

Angiogenic Biomarkers For Risk Stratification In Women With Suspected Preeclampsia, Andreea Balan, Heather Young, Linda Ojo, Jennifer Keller, Sharon Maynard

Epidemiology Faculty Posters and Presentations

This poster presents the results of a single-center prospective cohort study of 315 pregnant women who presented to George Washington University Hospital Labor and Delivery service with a clinical suspicion of preeclampsia between February 2007 and November 2011. Informed consent was obtained. Baseline demographic information and medical history was collected on each patient including maternal age, ethnicity, body mass index, tobacco and other substance use, gestational age, medical problems and obstetric history. Serum samples were obtained from each enrolled subject within 24 hours of admission, and sFlt1, PlGF and sEng ELISA assays were performed in duplicate by a blinded laboratory …

A Novel Device For Cell-Cell Electrofusion, Justin T. Stewart

USF Tampa Graduate Theses and Dissertations

Cell transplantation therapy is a potentially powerful tool and can be used to replace defective cells with healthy cells. This offers the possibility of alleviating the destructive symptoms for many diseases such as Parkinson's disease, Alzheimer's disease, stroke, spinal cord trauma, Type I diabetes and many more. While there are many diseases that could be positively impacted from cell transplantation therapy, the focus of this research is insulin dependent, Type I Diabetes.

The Islets of Langerhans are composed of various types of cells located in the pancreas and are responsible for a variety of biochemical functions. Specifically, the beta Islet …

Statistical Models For Environmental And Health Sciences, Yong Xu

USF Tampa Graduate Theses and Dissertations

Statistical analysis and modeling are useful for understanding the behavior of different phenomena. In this study we will focus on two areas of applications: Global warming and cancer research. Global Warming is one of the major environmental challenge people face nowadays and cancer is one of the major health problem that people need to solve.

For Global Warming, we are interest to do research on two major contributable variables: Carbon dioxide (CO2) and atmosphere temperature. We will model carbon dioxide in the atmosphere data with a system of differential equations. We will develop a differential equation for each of six …

Analysis Of Differential Gene Expression And Alternative Splicing In The Liver And Gastrointestinal Tract In The Lactating Rat, Antony Thomas Athippozhy

University of Kentucky Doctoral Dissertations

Rat exon microarrays were utilized to detect changes in mRNA expression and alternative splicing in the liver, duodenum, jejunum, and ileum of the lactating rat when compared to age-matched virgin controls. Analysis of data at the level of gene expression revealed differential expression of genes involved in cholesterol biosynthesis in each tissue examined, suggesting increased Sterol Response Element Binding Protein activity. We also detected decreased mRNA from components of the T-cell signaling pathway in the jejunum and ileum. We characterized expression of solute carrier and adenosine triphosphate binding cassette proteins. In addition to characterizing genes by pathway, we have also …

Gender Differences In Lung Cancer Treatment And Survival, Margaret Anne Kowski

USF Tampa Graduate Theses and Dissertations

The objectives of this research were to test treatment and survival differences between women and men with lung cancer as there is minimal investigation in the literature. Three research questions were developed with statistical testing for gender differences based on similar cancer type, stage, treatment assignment and survival. Data for 44,863 primary lung cancer cases were collected from eight U.S. state-based cancer registries to investigate the research questions. The lung cancer incidence data included the morphological cell-types of adenocarcinoma (AC); squamous cell carcinoma (SCC); large cell carcinoma (LCC) and small cell carcinoma (SCC). Stage, grade, treatment type, as well as, …