Categorical Data Analysis Commons^™

Models For Hsv Shedding Must Account For Two Levels Of Overdispersion, Amalia Magaret

UW Biostatistics Working Paper Series

We have frequently implemented crossover studies to evaluate new therapeutic interventions for genital herpes simplex virus infection. The outcome measured to assess the efficacy of interventions on herpes disease severity is the viral shedding rate, defined as the frequency of detection of HSV on the genital skin and mucosa. We performed a simulation study to ascertain whether our standard model, which we have used previously, was appropriately considering all the necessary features of the shedding data to provide correct inference. We simulated shedding data under our standard, validated assumptions and assessed the ability of 5 different models to reproduce the …

The Net Reclassification Index (Nri): A Misleading Measure Of Prediction Improvement With Miscalibrated Or Overfit Models, Margaret Pepe, Jin Fang, Ziding Feng, Thomas Gerds, Jorgen Hilden

UW Biostatistics Working Paper Series

The Net Reclassification Index (NRI) is a very popular measure for evaluating the improvement in prediction performance gained by adding a marker to a set of baseline predictors. However, the statistical properties of this novel measure have not been explored in depth. We demonstrate the alarming result that the NRI statistic calculated on a large test dataset using risk models derived from a training set is likely to be positive even when the new marker has no predictive information. A related theoretical example is provided in which a miscalibrated risk model that includes an uninformative marker is proven to erroneously …

A Censored Multinomial Regression Model For Perinatal Mother To Child Transmission Of Hiv, Charlotte C. Gard, Elizabeth R. Brown

UW Biostatistics Working Paper Series

In studies designed to estimate rates of perinatal mother to child transmission of HIV, HIV assays are scheduled at multiple points in time. Still infection status for some infants at some time points is often unknown, particularly when interim analyses are conducted. Logistic regression and Cox proportional hazards regression are commonly used to estimate covariate-adjusted transmission rates, but their methods for handling missing data may be inadequate. Here, we propose using censored multinomial regression models to estimate cumulative and conditional rates of HIV transmission. Through simulation, we show that the proposed methods perform better than standard logistic models in terms …

Semi-Parametric Single-Index Two-Part Regression Models, Xiao-Hua Zhou, Hua Liang

UW Biostatistics Working Paper Series

In this paper, we proposed a semi-parametric single-index two-part regression model to weaken assumptions in parametric regression methods that were frequently used in the analysis of skewed data with additional zero values. The estimation procedure for the parameters of interest in the model was easily implemented. The proposed estimators were shown to be consistent and asymptotically normal. Through a simulation study, we showed that the proposed estimators have reasonable finite-sample performance. We illustrated the application of the proposed method in one real study on the analysis of health care costs.

Incorporating Death Into Health-Related Variables In Longitudinal Studies, Paula Diehr, Laura Lee Johnson, Donald L. Patrick, Bruce Psaty

UW Biostatistics Working Paper Series

Background: The aging process can be described as the change in health-related variables over time. Unfortunately, simple graphs of available data may be misleading if some people die, since they may confuse patterns of mortality with patterns of change in health. Methods have been proposed to incorporate death into self-rated health (excellent to poor) and the SF-36 profile scores, but not for other variables.

Objectives: (1) To incorporate death into the following variables: ADLs, IADLs, mini-mental state examination, depressive symptoms, body mass index (BMI), blocks walked per week, bed days, hospitalization, systolic blood pressure, and the timed walk. (2) To …

Marginalized Transition Models For Longitudinal Binary Data With Ignorable And Nonignorable Dropout, Brenda F. Kurland, Patrick J. Heagerty

UW Biostatistics Working Paper Series

We extend the marginalized transition model of Heagerty (2002) to accommodate nonignorable monotone dropout. Using a selection model, weakly identified dropout parameters are held constant and their effects evaluated through sensitivity analysis. For data missing at random (MAR), efficiency of inverse probability of censoring weighted generalized estimating equations (IPCW-GEE) is as low as 40% compared to a likelihood-based marginalized transition model (MTM) with comparable modeling burden. MTM and IPCW-GEE regression parameters both display misspecification bias for MAR and nonignorable missing data, and both reduce bias noticeably by improving model fit

Marginal Modeling Of Multilevel Binary Data With Time-Varying Covariates, Diana Miglioretti, Patrick Heagerty

UW Biostatistics Working Paper Series

We propose and compare two approaches for regression analysis of multilevel binary data when clusters are not necessarily nested: a GEE method that relies on a working independence assumption coupled with a three-step method for obtaining empirical standard errors; and a likelihood-based method implemented using Bayesian computational techniques. Implications of time-varying endogenous covariates are addressed. The methods are illustrated using data from the Breast Cancer Surveillance Consortium to estimate mammography accuracy from a repeatedly screened population.

A New Confidence Interval For The Difference Between Two Binomial Proportions Of Paired Data, Xiao-Hua Zhou, Gengsheng Qin

UW Biostatistics Working Paper Series

Motivated by a study on comparing sensitivities and specificities of two diagnostic tests in a paired design when the sample size is small, we first derived an Edgeworth expansion for the studentized difference between two binomial proportions of paired data. The Edgeworth expansion can help us understand why the usual Wald interval for the difference has poor coverage performance in the small sample size. Based on the Edgeworth expansion, we then derived a transformation based confidence interval for the difference. The new interval removes the skewness in the Edgeworth expansion; the new interval is easy to compute, and its coverage …

Improved Confidence Intervals For The Sensitivity At A Fixed Level Of Specificity Of A Continuous-Scale Diagnostic Test, Xiao-Hua Zhou, Gengsheng Qin

UW Biostatistics Working Paper Series

For a continuous-scale test, it is an interest to construct a confidence interval for the sensitivity of the diagnostic test at the cut-off that yields a predetermined level of its specificity (eg. 80%, 90%, or 95%). IN this paper we proposed two new intervals for the sensitivity of a continuous-scale diagnostic test at a fixed level of specificity. We then conducted simulation studies to compare the relative performance of these two intervals with the best existing BCa bootstrap interval, proposed by Platt et al. (2000). Our simulation results showed that the newly proposed intervals are better than the BCa bootstrap …

New Intervals For The Difference Between Two Independent Binomial Proportions, Xiao-Hua Zhou, Min Tsao, Gengsheng Qin

UW Biostatistics Working Paper Series

In this paper we gave an Edgeworth expansion for the studentized difference of two binomial proportions. We then proposed two new intervals by correcting the skewness in the Edgeworth expansion in a direct and an indirect way. Such the bias-correct confidence intervals are easy to compute, and their coverage probabilities converge to the nominal level at a rate of O(n-½), where n is the size of the combined samples. Our simulation results suggest tat in finite samples the new interval based on the indirect method have the similar performance to the two best existing intervals in terms of coverage accuracy …

Partial Auc Estimation And Regression, Lori E. Dodd, Margaret S. Pepe

UW Biostatistics Working Paper Series

Accurate disease diagnosis is critical for health care. New diagnostic and screening tests must be evaluated for their abilities to discriminate disease from non-diseased states. The partial area under the ROC curve (partial AUC) is a measure of diagnostic test accuracy. We present an interpretation of the partial AUC that gives rise to a new non-parametric estimator. This estimator is more robust than existing estimators, which make parametric assumptions. We show that the robustness is gained with only a moderate loss in efficiency. We describe a regression modelling framework for making inference about covariate effects on the partial AUC. Such …