Abstract

CASTANEDA, JAVIER  and  GERRITSE, BART. Appraisal of Several Methods to Model Time to Multiple Events per Subject: Modelling Time to Hospitalizations and Death. Rev.Colomb.Estad. [online]. 2010, vol.33, n.1, pp.43-61. ISSN 0120-1751.

During the disease-recovery process of many diseases, such as in Heart Failure (HF), often more than one type of event plays a role. Some clinical trials use the combined endpoint of death and a secondary event; for instance, HF-related hospitalizations. This is often analyzed with time-to-first-event survival analysis which ignores possible subsequent events, such as several HF-related hospitalizations. Accounting for multiple events provides more detailed information on the disease-control process, and allows a more precise understanding of the prognosis of patients. In this paper we explore and illustrate several modelling strategies to study time to repeated events of disease-related hospitalizations and death per subject. Marginal models are revised in order to account for intra-subject correlation and competing risks. Finally, we recommend a Multi-state model which allows a flexible modelling strategy that incorporates important features in the analysis of HF-related hospitalizations and death, and at the same time extends relevant characteristics of the Andersen & Gill (1982), Wei et al. (1989) and Prentice et al. (1981) models.

Keywords : Survival analysis; Competing risks; Correlated observations; Marginal models.

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