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Design and analysis of nested case–control studies for recurrent events subject to a terminal event

Journal Article · · Statistics in Medicine
DOI:https://doi.org/10.1002/sim.8302· OSTI ID:1532770
 [1];  [1];  [2];  [3];  [4]
  1. Department of Biostatistics Harvard T.H. Chan School of Public Health Boston Massachusetts
  2. Department of Statistics Radiation Effects Research Foundation Hiroshima Japan
  3. Department of Biopathology Institut Bergonié Bordeaux France
  4. Centre de recherche INSERM U1219 Université de Bordeaux–ISPED Bordeaux France

The process by which patients experience a series of recurrent events, such as hospitalizations, may be subject to death. In cohort studies, one strategy for analyzing such data is to fit a joint frailty model for the intensities of the recurrent event and death, which estimates covariate effects on the two event types while accounting for their dependence. When certain covariates are difficult to obtain, however, researchers may only have the resources to subsample patients on whom to collect complete data: one way is using the nested case–control (NCC) design, in which risk set sampling is performed based on a single outcome. We develop a general framework for the design of NCC studies in the presence of recurrent and terminal events and propose estimation and inference for a joint frailty model for recurrence and death using data arising from such studies. We propose a maximum weighted penalized likelihood approach using flexible spline models for the baseline intensity functions. Two standard error estimators are proposed: a sandwich estimator and a perturbation resampling procedure. We investigate operating characteristics of our estimators as well as design considerations via a simulation study and illustrate our methods using two studies: one on recurrent cardiac hospitalizations in patients with heart failure and the other on local recurrence and metastasis in patients with breast cancer.

Sponsoring Organization:
USDOE
Grant/Contract Number:
HS0000031
OSTI ID:
1532770
Alternate ID(s):
OSTI ID: 1613761
Journal Information:
Statistics in Medicine, Journal Name: Statistics in Medicine Journal Issue: 22 Vol. 38; ISSN 0277-6715
Publisher:
Wiley Blackwell (John Wiley & Sons)Copyright Statement
Country of Publication:
United Kingdom
Language:
English

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