In order to evaluate the reliability of long-lifetime products with degradation data, a new proportional hazard degradation model is proposed. By the similarity between time-degradation data and stress-accelerated lif...In order to evaluate the reliability of long-lifetime products with degradation data, a new proportional hazard degradation model is proposed. By the similarity between time-degradation data and stress-accelerated lifetime, and the failure rate function of degradation data which is assumed to be proportional to the time covariate, the reliability assessment based on a proportional hazard degradation model is realized. The least squares method is used to estimate the model's parameters. Based on the failure rate of the degradation data and the proportion function of the known time, the failure rate and the reliability function under the given time and the predetermined failure threshold can be extrapolated. A long life GaAs laser is selected as a case study and its reliability is evaluated. The results show that the proposed method can accurately describe the degradation process and it is effective for the reliability assessment of long lifetime products.展开更多
As the central component of rotating machine,the performance reliability assessment and remaining useful lifetime prediction of bearing are of crucial importance in condition-based maintenance to reduce the maintenanc...As the central component of rotating machine,the performance reliability assessment and remaining useful lifetime prediction of bearing are of crucial importance in condition-based maintenance to reduce the maintenance cost and improve the reliability.A prognostic algorithm to assess the reliability and forecast the remaining useful lifetime(RUL) of bearings was proposed,consisting of three phases.Online vibration and temperature signals of bearings in normal state were measured during the manufacturing process and the most useful time-dependent features of vibration signals were extracted based on correlation analysis(feature selection step).Time series analysis based on neural network,as an identification model,was used to predict the features of bearing vibration signals at any horizons(feature prediction step).Furthermore,according to the features,degradation factor was defined.The proportional hazard model was generated to estimate the survival function and forecast the RUL of the bearing(RUL prediction step).The positive results show that the plausibility and effectiveness of the proposed approach can facilitate bearing reliability estimation and RUL prediction.展开更多
An approach for web server cluster(WSC)reliability and degradation process analysis is proposed.The reliability process is modeled as a non-homogeneous Markov process(NHMH)composed of several non-homogeneous Poisson p...An approach for web server cluster(WSC)reliability and degradation process analysis is proposed.The reliability process is modeled as a non-homogeneous Markov process(NHMH)composed of several non-homogeneous Poisson processes(NHPPs).The arrival rate of each NHPP corresponds to the system software failure rate which is expressed using Cox s proportional hazards model(PHM)in terms of the cumulative and instantaneous load of the software.The cumulative load refers to software cumulative execution time,and the instantaneous load denotes the rate that the users requests arrive at a server.The result of reliability analysis is a time-varying reliability and degradation process over the WSC lifetime.Finally,the evaluation experiment shows the effectiveness of the proposed approach.展开更多
Penalized empirical likelihood inferential procedure is proposed for Cox's pro- portional hazards model with adaptive LASSO(ALASSO). Under reasonable conditions, we show that the proposed method has oracle property...Penalized empirical likelihood inferential procedure is proposed for Cox's pro- portional hazards model with adaptive LASSO(ALASSO). Under reasonable conditions, we show that the proposed method has oracle property and the limiting distribution of a penal- ized empirical likelihood ratio via ALASSO is a chi-square distributions. The advantage of penalized empirical likelihood is illustrated in testing hypothesis and constructing confidence sets by simulation studies and a real example.展开更多
Cox Proportional Hazard model is a popular statistical technique for exploring the relationship between the survival time of neonates and several explanatory variables. It provides an estimate of the study variables’...Cox Proportional Hazard model is a popular statistical technique for exploring the relationship between the survival time of neonates and several explanatory variables. It provides an estimate of the study variables’ effect on survival after adjustment for other explanatory variables, and allows us to estimate the hazard (or risk) of death of newborn in NICU of hospitals in River Nile State-Sudan for the period (2018-2020). Study Data represented (neonate gender, mode of delivery, birth type, neonate weight, resident type, gestational age, and survival time). Kaplan-Meier method is used to estimate survival and hazard function for survival times of newborns that have not completed their first month. Of 700 neonates in the study area, 25% of them died during 2018-2020. Variables of interest that had a significant effect on neonatal death by Cox Proportional Hazard Model analysis were neonate weight, resident type, and gestational age. In Cox Proportional Hazard Model analysis all the variables of interest had an effect on neonatal death, but the variables with a significant effect included, weight of neonate, resident type and gestational age.展开更多
BACKGROUND The growing disparity between the rising demand for liver transplantation(LT)and the limited availability of donor organs has prompted a greater reliance on older liver grafts.Traditionally,utilizing livers...BACKGROUND The growing disparity between the rising demand for liver transplantation(LT)and the limited availability of donor organs has prompted a greater reliance on older liver grafts.Traditionally,utilizing livers from elderly donors has been associated with outcomes inferior to those achieved with grafts from younger donors.By accounting for additional risk factors,we hypothesize that the utili-zation of older liver grafts has a relatively minor impact on both patient survival and graft viability.AIM To evaluate the impact of donor age on LT outcomes using multivariate analysis and comparing young and elderly donor groups.METHODS In the period from April 2013 to December 2018,656 adult liver transplants were performed at the University Hospital Merkur.Several multivariate Cox propor-tional hazards models were developed to independently assess the significance of donor age.Donor age was treated as a continuous variable.The approach involved univariate and multivariate analysis,including variable selection and assessment of interactions and transformations.Additionally,to exemplify the similarity of using young and old donor liver grafts,the group of 87 recipients of elderly donor liver grafts(≥75 years)was compared to a group of 124 recipients of young liver grafts(≤45 years)from the dataset.Survival rates of the two groups were estimated using the Kaplan-Meier method and the log-rank test was used to test the differences between groups.RESULTS Using multivariate Cox analysis,we found no statistical significance in the role of donor age within the constructed models.Even when retained during the entire model development,the donor age's impact on survival remained insignificant and transformations and interactions yielded no substantial effects on survival.Consistent insigni-ficance and low coefficient values suggest that donor age does not impact patient survival in our dataset.Notably,there was no statistical evidence that the five developed models did not adhere to the proportional hazards assumption.When comparing donor age groups,transplantation using elderly grafts showed similar early graft function,similar graft(P=0.92),and patient survival rates(P=0.86),and no significant difference in the incidence of postoperative complications.CONCLUSION Our center's experience indicates that donor age does not play a significant role in patient survival,with elderly livers performing comparably to younger grafts when accounting for other risk factors.展开更多
Exclusive hypothesis testing is a new and special class of hypothesis testing.This kind of testing can be applied in survival analysis to understand the association between genomics information and clinical informatio...Exclusive hypothesis testing is a new and special class of hypothesis testing.This kind of testing can be applied in survival analysis to understand the association between genomics information and clinical information about the survival time.Besides,it is well known that Cox's proportional hazards model is the most commonly used model for regression analysis of failure time.In this paper,the authors consider doing the exclusive hypothesis testing for Cox's proportional hazards model with right-censored data.The authors propose the comprehensive test statistics to make decision,and show that the corresponding decision rule can control the asymptotic TypeⅠerrors and have good powers in theory.The numerical studies indicate that the proposed approach works well for practical situations and it is applied to a set of real data arising from Rotterdam Breast Cancer Data study that motivated this study.展开更多
Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives ...Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.展开更多
Chronic hepatitis B(CHB)-related hepatocellular carcinoma(HCC)is a major health problem in Asian-Pacific regions.Antiviral therapy reduces,but does not completely prevent,HCC development.Thus,there is a need for accur...Chronic hepatitis B(CHB)-related hepatocellular carcinoma(HCC)is a major health problem in Asian-Pacific regions.Antiviral therapy reduces,but does not completely prevent,HCC development.Thus,there is a need for accurate risk prediction to assist prognostication and decisions on the need for antiviral therapy and HCC surveillance.A few risk scores have been developed to predict the occurrence of HCC in CHB patients.Initially,the scores were derived from untreated CHB patients.With the development and extensive clinical application of nucleos(t)ide analog(s)(NA),the number of risk scores based on treated CHB patients has increased gradually.The components included in risk scores may be categorized into host factors and hepatitis B virus factors.Hepatitis activities,hepatitis B virus factors,and even liver fibrosis or cirrhosis are relatively controlled by antiviral therapy.Therefore,variables that are more dynamic during antiviral therapy have since been included in risk scores.However,host factors are more difficult to modify.Most existing scores derived from Asian populations have been confirmed to be accurate in predicting HCC development in CHB patients from Asia,while these scores have not offered excellent predictability in Caucasian patients.These findings support that more relevant variables should be considered to provide individualized predictions that are easily applied to CHB patients of different ethnicities.CHB patients should receive different intensities of HCC surveillance according to their risk category.展开更多
When the event of interest never occurs for a proportion of subjects during the study period, survival models with a cure fraction are more appropriate in analyzing this type of data. Considering the non-linear relati...When the event of interest never occurs for a proportion of subjects during the study period, survival models with a cure fraction are more appropriate in analyzing this type of data. Considering the non-linear relationship between response variable and covariates, we propose a class of generalized transformation models motivated by Zeng et al. [1] transformed proportional time cure model, in which fractional polynomials are used instead of the simple linear combination of the covariates. Statistical properties of the proposed models are investigated, including identifiability of the parameters, asymptotic consistency, and asymptotic normality of the estimated regression coefficients. A simulation study is carried out to examine the performance of the power selection procedure. The generalized transformation cure rate models are applied to the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study (NHANES1) for the purpose of examining the relationship between survival time of patients and several risk factors.展开更多
BACKGROUND Fibrinogen-to-albumin ratio(FAR)has been found to be of prognostic significance for several types of malignant tumors.However,less is known about the association between FAR and survival outcomes in hepatoc...BACKGROUND Fibrinogen-to-albumin ratio(FAR)has been found to be of prognostic significance for several types of malignant tumors.However,less is known about the association between FAR and survival outcomes in hepatocellular carcinoma(HCC)patients.AIM To explore the association between FAR and prognosis and survival in patients with HCC.METHODS A total of 366 histologically confirmed HCC patients diagnosed between 2013 and 2018 in a provincial cancer hospital in southwestern China were retrospectively selected.Relevant data were extracted from the hospital information system.The optimal cutoff for baseline serum FAR measured upon disease diagnosis was established using the receiver operating characteristic(ROC)curve.Univariate and multivariate Cox proportional hazards models were used to determine the crude and adjusted associations between FAR and the overall survival(OS)of the HCC patients while controlling for various covariates.The restricted cubic spline(RCS)was applied to estimate the dose-response trend in the FAR-OS association.RESULTS The optimal cutoff value for baseline FAR determined by the ROC was 0.081.Multivariate Cox proportional hazards model revealed that a lower baseline serum FAR level was associated with an adjusted hazard ratio of 2.43(95%confidence interval:1.87–3.15)in the OS of HCC patients,with identifiable dose-response trend in the RCS.Subgroup analysis showed that this FAR-OS association was more prominent in HCC patients with a lower baseline serum aspartate aminotransferase or carbohydrate antigen 125 level.CONCLUSION Serum FAR is a prominent prognostic indicator for HCC.Intervention measures aimed at reducing FAR might result in survival benefit for HCC patients.展开更多
OBJECTIVE: To evaluate the influence of various clinicopathologic factors on the survival of patients with bile duct carcinoma after curative resection. METHODS: A retrospective analysis was performed on 86 cases of b...OBJECTIVE: To evaluate the influence of various clinicopathologic factors on the survival of patients with bile duct carcinoma after curative resection. METHODS: A retrospective analysis was performed on 86 cases of bile duct carcinoma treated from January 1981 to September 1995. Fifteen clinicopathologic factors that could possibly influence survival were selected. A multivariate analysis of these individuals was performed using the Cox Proportional Hazards Model. RESULTS: The overall cumulative survival rate was 73% for 1 year, 32% for 3 years and 19% for 5 years. The results of univariate analysis showed that the major significant prognostic factors for influencing survival of these patients were type of histological lesion, lymph node metastasis, pancreatic invasion, duodenal invasion, perineural invasion, macroscopic vessel involvement, resected surgical margin and depth of cancer invasion (P展开更多
<strong>Background: </strong><span style="font-family:""><span style="font-family:Verdana;">One of the main objectives of hospital managements is to control the length ...<strong>Background: </strong><span style="font-family:""><span style="font-family:Verdana;">One of the main objectives of hospital managements is to control the length of stay (LOS). Successful control of LOS of inpatients will result in reduction in the cost of care, decrease in nosocomial infections, medication side effects, and better management of the limited number of available patients’ beds. The length of stay (LOS) is an important indicator of the efficiency of hospital management by improving the quality of treatment, and increased hospital profit with more efficient bed management. The purpose of this study was to model the distribution of LOS as a function of patient’s age, and the Diagnosis Related Groups (DRG), based on electronic medical records of a large tertiary care hospital. </span><b><span style="font-family:Verdana;">Materials and Methods: </span></b><span style="font-family:Verdana;">Information related to the research subjects were retrieved from a database of patients admitted to King Faisal Specialist Hospital and Research Center hospital in Riyadh, Saudi Arabia between January 2014 and December 2016. Subjects’ confidential information was masked from the investigators. The data analyses were reported visually, descriptively, and analytically using Cox proportional hazard regression model to predict the risk of long-stay when patients’ age and the DRG are considered as antecedent risk factors. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Predicting the risk of long stay depends significantly on the age at admission, and the DRG to which a patient belongs to. We demonstrated the validity of the Cox regression model for the available data as the proportionality assumption is shown to be satisfied. Two examples were presented to demonstrate the utility of the Cox model in this regard.</span></span>展开更多
The smooth integration of counting and absolute deviation (SICA) penalized variable selection procedure for high-dimensional linear regression models is proposed by Lv and Fan (2009). In this article, we extend th...The smooth integration of counting and absolute deviation (SICA) penalized variable selection procedure for high-dimensional linear regression models is proposed by Lv and Fan (2009). In this article, we extend their idea to Cox's proportional hazards (PH) model by using a penalized log partial likelihood with the SICA penalty. The number of the regression coefficients is allowed to grow with the sample size. Based on an approximation to the inverse of the Hessian matrix, the proposed method can be easily carried out with the smoothing quasi-Newton (SQN) algorithm. Under appropriate sparsity conditions, we show that the resulting estimator of the regression coefficients possesses the oracle property. We perform an extensive simulation study to compare our approach with other methods and illustrate it on a well known PBC data for predicting survival from risk factors.展开更多
AIM:To investigate the efficiency of Cox proportional hazard model in detecting prognostic factors for gastric cancer.METHODS:We used the log-normal regression model to evaluate prognostic factors in gastric cancer an...AIM:To investigate the efficiency of Cox proportional hazard model in detecting prognostic factors for gastric cancer.METHODS:We used the log-normal regression model to evaluate prognostic factors in gastric cancer and compared it with the Cox model.Three thousand and eighteen gastric cancer patients who received a gastrectomy between 1980 and 2004 were retrospectively evaluated.Clinic-pathological factors were included in a log-normal model as well as Cox model.The akaike information criterion (AIC) was employed to compare the efficiency of both models.Univariate analysis indicated that age at diagnosis,past history,cancer location,distant metastasis status,surgical curative degree,combined other organ resection,Borrmann type,Lauren's classification,pT stage,total dissected nodes and pN stage were prognostic factors in both log-normal and Cox models.RESULTS:In the final multivariate model,age at diagnosis,past history,surgical curative degree,Borrmann type,Lauren's classification,pT stage,and pN stage were significant prognostic factors in both log-normal and Cox models.However,cancer location,distant metastasis status,and histology types were found to be significant prognostic factors in log-normal results alone.According to AIC,the log-normal model performed better than the Cox proportional hazard model (AIC value:2534.72 vs 1693.56).CONCLUSION:It is suggested that the log-normal regression model can be a useful statistical model to evaluate prognostic factors instead of the Cox proportional hazard model.展开更多
This paper proposes a health evaluation method for degrading systems subject to competing risks of dependent soft and hard failures. To characterize the time-varying degradation rate, the degradation process is determ...This paper proposes a health evaluation method for degrading systems subject to competing risks of dependent soft and hard failures. To characterize the time-varying degradation rate, the degradation process is determined by a non-stationary Gamma process and the soft failure is encountered when it exceeds a predefined critical level. For the hard failure, a Cox’s proportional hazard model is applied to describe the hazard rate of the time to system failure. The dependent relationship is modeled by incorporating the degradation process as a time-varying covariate into the Cox’s proportional hazard model. To facilitate the health characteristics evaluation, a discretization technique is applied both to the degradation process and the monitoring time.All health characteristics can be obtained in the explicit form using the transition probability matrix, which is computationally attractive for practical applications. Finally, a numerical analysis is carried out to show the effectiveness and the performance of the proposed health evaluation method.展开更多
Generalized case-cohort design has been proved to be a cost-effective way to enhance the efficiency of large epidemiological cohort. In this article, we propose an inference procedure for estimating the unknown parame...Generalized case-cohort design has been proved to be a cost-effective way to enhance the efficiency of large epidemiological cohort. In this article, we propose an inference procedure for estimating the unknown parameters in Cox's proportional hazards model in generalized case-cohort design and establish an optimal sample size allocation to achieve the maximum power at a given budget. The finite sample performance of the proposed method is evaluated through simulation studies. The proposed method is applied to a real data set from the National Wilm's Tumor Study Group.展开更多
To reduce engine maintenance cost and support safe operation, a prediction method of engine life on wing was proposed. This method is a kind of regression model which is a function of the condition monitoring and fail...To reduce engine maintenance cost and support safe operation, a prediction method of engine life on wing was proposed. This method is a kind of regression model which is a function of the condition monitoring and failure data. Key causes of engine removals were analyzed, and the life limit due to performance deterioration was predicted by proportional hazards model. Then the scheduled removal causes were considered as constraints of engine life to predicte the finai life on wing. Application of the proposed prediction method to the case of CF6-80C2A5 engine fleet in an airline proved its effectiveness.展开更多
Objective: To evaluate the major prognostic factors in patients with pancreatic carcinoma. Methods:113 cases of a particular disease were retrospectively analysed and 9 factors for prognosis were studied by multiva...Objective: To evaluate the major prognostic factors in patients with pancreatic carcinoma. Methods:113 cases of a particular disease were retrospectively analysed and 9 factors for prognosis were studied by multivaritate analysis with Cox proportional hazards survival model.Survival rate was calculated by Kaplan-Meier estimation. Results:In this group,survival time was 0.1 to 82 months,and the median survival time was 3 months.Overall survival rates at month 6,12,18,36 were 35.6%,20.3%,15.9% and 6.2%,respectively.Multivariate analyses revealed significant prognostic factors as follows:jaundice,metastasis,therapy method and synthetic therapy. Conclusion: The prognosis of pancreatic carcinoma is determined by various factors.Jaundice and metastasis are independent predictors of poor survival.Radical operation and synthetic therapy will improve the prognosis.展开更多
Recurrent events data and gap times between recurrent events are frequently encountered in many clinical and observational studies,and often more than one type of recurrent events is of interest.In this paper,we consi...Recurrent events data and gap times between recurrent events are frequently encountered in many clinical and observational studies,and often more than one type of recurrent events is of interest.In this paper,we consider a proportional hazards model for multiple type recurrent gap times data to assess the effect of covaxiates on the censored event processes of interest.An estimating equation approach is used to obtain the estimators of regression coefficients and baseline cumulative hazard functions.We examine asymptotic properties of the proposed estimators.Finite sample properties of these estimators are demonstrated by simulations.展开更多
基金The National Natural Science Foundation of China (No.50405021)
文摘In order to evaluate the reliability of long-lifetime products with degradation data, a new proportional hazard degradation model is proposed. By the similarity between time-degradation data and stress-accelerated lifetime, and the failure rate function of degradation data which is assumed to be proportional to the time covariate, the reliability assessment based on a proportional hazard degradation model is realized. The least squares method is used to estimate the model's parameters. Based on the failure rate of the degradation data and the proportion function of the known time, the failure rate and the reliability function under the given time and the predetermined failure threshold can be extrapolated. A long life GaAs laser is selected as a case study and its reliability is evaluated. The results show that the proposed method can accurately describe the degradation process and it is effective for the reliability assessment of long lifetime products.
基金Project(61174115)supported by the National Natural Science Foundation of ChinaProject(L2013001)supported by Scientific Research Program of Liaoning Provincial Education Department,China
文摘As the central component of rotating machine,the performance reliability assessment and remaining useful lifetime prediction of bearing are of crucial importance in condition-based maintenance to reduce the maintenance cost and improve the reliability.A prognostic algorithm to assess the reliability and forecast the remaining useful lifetime(RUL) of bearings was proposed,consisting of three phases.Online vibration and temperature signals of bearings in normal state were measured during the manufacturing process and the most useful time-dependent features of vibration signals were extracted based on correlation analysis(feature selection step).Time series analysis based on neural network,as an identification model,was used to predict the features of bearing vibration signals at any horizons(feature prediction step).Furthermore,according to the features,degradation factor was defined.The proportional hazard model was generated to estimate the survival function and forecast the RUL of the bearing(RUL prediction step).The positive results show that the plausibility and effectiveness of the proposed approach can facilitate bearing reliability estimation and RUL prediction.
基金The National Natural Science Foundation of China(No.61402333,61402242)the National Science Foundation of Tianjin(No.15JCQNJC00400)
文摘An approach for web server cluster(WSC)reliability and degradation process analysis is proposed.The reliability process is modeled as a non-homogeneous Markov process(NHMH)composed of several non-homogeneous Poisson processes(NHPPs).The arrival rate of each NHPP corresponds to the system software failure rate which is expressed using Cox s proportional hazards model(PHM)in terms of the cumulative and instantaneous load of the software.The cumulative load refers to software cumulative execution time,and the instantaneous load denotes the rate that the users requests arrive at a server.The result of reliability analysis is a time-varying reliability and degradation process over the WSC lifetime.Finally,the evaluation experiment shows the effectiveness of the proposed approach.
文摘Penalized empirical likelihood inferential procedure is proposed for Cox's pro- portional hazards model with adaptive LASSO(ALASSO). Under reasonable conditions, we show that the proposed method has oracle property and the limiting distribution of a penal- ized empirical likelihood ratio via ALASSO is a chi-square distributions. The advantage of penalized empirical likelihood is illustrated in testing hypothesis and constructing confidence sets by simulation studies and a real example.
文摘Cox Proportional Hazard model is a popular statistical technique for exploring the relationship between the survival time of neonates and several explanatory variables. It provides an estimate of the study variables’ effect on survival after adjustment for other explanatory variables, and allows us to estimate the hazard (or risk) of death of newborn in NICU of hospitals in River Nile State-Sudan for the period (2018-2020). Study Data represented (neonate gender, mode of delivery, birth type, neonate weight, resident type, gestational age, and survival time). Kaplan-Meier method is used to estimate survival and hazard function for survival times of newborns that have not completed their first month. Of 700 neonates in the study area, 25% of them died during 2018-2020. Variables of interest that had a significant effect on neonatal death by Cox Proportional Hazard Model analysis were neonate weight, resident type, and gestational age. In Cox Proportional Hazard Model analysis all the variables of interest had an effect on neonatal death, but the variables with a significant effect included, weight of neonate, resident type and gestational age.
基金Supported by the European Regional Development Fund(DATACROSS),No.KK.01.1.1.01.0009.
文摘BACKGROUND The growing disparity between the rising demand for liver transplantation(LT)and the limited availability of donor organs has prompted a greater reliance on older liver grafts.Traditionally,utilizing livers from elderly donors has been associated with outcomes inferior to those achieved with grafts from younger donors.By accounting for additional risk factors,we hypothesize that the utili-zation of older liver grafts has a relatively minor impact on both patient survival and graft viability.AIM To evaluate the impact of donor age on LT outcomes using multivariate analysis and comparing young and elderly donor groups.METHODS In the period from April 2013 to December 2018,656 adult liver transplants were performed at the University Hospital Merkur.Several multivariate Cox propor-tional hazards models were developed to independently assess the significance of donor age.Donor age was treated as a continuous variable.The approach involved univariate and multivariate analysis,including variable selection and assessment of interactions and transformations.Additionally,to exemplify the similarity of using young and old donor liver grafts,the group of 87 recipients of elderly donor liver grafts(≥75 years)was compared to a group of 124 recipients of young liver grafts(≤45 years)from the dataset.Survival rates of the two groups were estimated using the Kaplan-Meier method and the log-rank test was used to test the differences between groups.RESULTS Using multivariate Cox analysis,we found no statistical significance in the role of donor age within the constructed models.Even when retained during the entire model development,the donor age's impact on survival remained insignificant and transformations and interactions yielded no substantial effects on survival.Consistent insigni-ficance and low coefficient values suggest that donor age does not impact patient survival in our dataset.Notably,there was no statistical evidence that the five developed models did not adhere to the proportional hazards assumption.When comparing donor age groups,transplantation using elderly grafts showed similar early graft function,similar graft(P=0.92),and patient survival rates(P=0.86),and no significant difference in the incidence of postoperative complications.CONCLUSION Our center's experience indicates that donor age does not play a significant role in patient survival,with elderly livers performing comparably to younger grafts when accounting for other risk factors.
基金supported by the National Natural Science Foundation of China under Grant Nos.11971064,12371262,and 12171374。
文摘Exclusive hypothesis testing is a new and special class of hypothesis testing.This kind of testing can be applied in survival analysis to understand the association between genomics information and clinical information about the survival time.Besides,it is well known that Cox's proportional hazards model is the most commonly used model for regression analysis of failure time.In this paper,the authors consider doing the exclusive hypothesis testing for Cox's proportional hazards model with right-censored data.The authors propose the comprehensive test statistics to make decision,and show that the corresponding decision rule can control the asymptotic TypeⅠerrors and have good powers in theory.The numerical studies indicate that the proposed approach works well for practical situations and it is applied to a set of real data arising from Rotterdam Breast Cancer Data study that motivated this study.
基金supported by the National Natural Science Foundation of China,Nos.82071426,81873784Clinical Cohort Construction Program of Peking University Third Hospital,No.BYSYDL2019002(all to DF)。
文摘Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.
基金Supported by National Science and Technology Major Project of China,No.2018ZX10715-005-003-002Health Development and Scientific Research in the Capital,No.2018-1-2181.
文摘Chronic hepatitis B(CHB)-related hepatocellular carcinoma(HCC)is a major health problem in Asian-Pacific regions.Antiviral therapy reduces,but does not completely prevent,HCC development.Thus,there is a need for accurate risk prediction to assist prognostication and decisions on the need for antiviral therapy and HCC surveillance.A few risk scores have been developed to predict the occurrence of HCC in CHB patients.Initially,the scores were derived from untreated CHB patients.With the development and extensive clinical application of nucleos(t)ide analog(s)(NA),the number of risk scores based on treated CHB patients has increased gradually.The components included in risk scores may be categorized into host factors and hepatitis B virus factors.Hepatitis activities,hepatitis B virus factors,and even liver fibrosis or cirrhosis are relatively controlled by antiviral therapy.Therefore,variables that are more dynamic during antiviral therapy have since been included in risk scores.However,host factors are more difficult to modify.Most existing scores derived from Asian populations have been confirmed to be accurate in predicting HCC development in CHB patients from Asia,while these scores have not offered excellent predictability in Caucasian patients.These findings support that more relevant variables should be considered to provide individualized predictions that are easily applied to CHB patients of different ethnicities.CHB patients should receive different intensities of HCC surveillance according to their risk category.
文摘When the event of interest never occurs for a proportion of subjects during the study period, survival models with a cure fraction are more appropriate in analyzing this type of data. Considering the non-linear relationship between response variable and covariates, we propose a class of generalized transformation models motivated by Zeng et al. [1] transformed proportional time cure model, in which fractional polynomials are used instead of the simple linear combination of the covariates. Statistical properties of the proposed models are investigated, including identifiability of the parameters, asymptotic consistency, and asymptotic normality of the estimated regression coefficients. A simulation study is carried out to examine the performance of the power selection procedure. The generalized transformation cure rate models are applied to the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study (NHANES1) for the purpose of examining the relationship between survival time of patients and several risk factors.
文摘BACKGROUND Fibrinogen-to-albumin ratio(FAR)has been found to be of prognostic significance for several types of malignant tumors.However,less is known about the association between FAR and survival outcomes in hepatocellular carcinoma(HCC)patients.AIM To explore the association between FAR and prognosis and survival in patients with HCC.METHODS A total of 366 histologically confirmed HCC patients diagnosed between 2013 and 2018 in a provincial cancer hospital in southwestern China were retrospectively selected.Relevant data were extracted from the hospital information system.The optimal cutoff for baseline serum FAR measured upon disease diagnosis was established using the receiver operating characteristic(ROC)curve.Univariate and multivariate Cox proportional hazards models were used to determine the crude and adjusted associations between FAR and the overall survival(OS)of the HCC patients while controlling for various covariates.The restricted cubic spline(RCS)was applied to estimate the dose-response trend in the FAR-OS association.RESULTS The optimal cutoff value for baseline FAR determined by the ROC was 0.081.Multivariate Cox proportional hazards model revealed that a lower baseline serum FAR level was associated with an adjusted hazard ratio of 2.43(95%confidence interval:1.87–3.15)in the OS of HCC patients,with identifiable dose-response trend in the RCS.Subgroup analysis showed that this FAR-OS association was more prominent in HCC patients with a lower baseline serum aspartate aminotransferase or carbohydrate antigen 125 level.CONCLUSION Serum FAR is a prominent prognostic indicator for HCC.Intervention measures aimed at reducing FAR might result in survival benefit for HCC patients.
文摘OBJECTIVE: To evaluate the influence of various clinicopathologic factors on the survival of patients with bile duct carcinoma after curative resection. METHODS: A retrospective analysis was performed on 86 cases of bile duct carcinoma treated from January 1981 to September 1995. Fifteen clinicopathologic factors that could possibly influence survival were selected. A multivariate analysis of these individuals was performed using the Cox Proportional Hazards Model. RESULTS: The overall cumulative survival rate was 73% for 1 year, 32% for 3 years and 19% for 5 years. The results of univariate analysis showed that the major significant prognostic factors for influencing survival of these patients were type of histological lesion, lymph node metastasis, pancreatic invasion, duodenal invasion, perineural invasion, macroscopic vessel involvement, resected surgical margin and depth of cancer invasion (P
文摘<strong>Background: </strong><span style="font-family:""><span style="font-family:Verdana;">One of the main objectives of hospital managements is to control the length of stay (LOS). Successful control of LOS of inpatients will result in reduction in the cost of care, decrease in nosocomial infections, medication side effects, and better management of the limited number of available patients’ beds. The length of stay (LOS) is an important indicator of the efficiency of hospital management by improving the quality of treatment, and increased hospital profit with more efficient bed management. The purpose of this study was to model the distribution of LOS as a function of patient’s age, and the Diagnosis Related Groups (DRG), based on electronic medical records of a large tertiary care hospital. </span><b><span style="font-family:Verdana;">Materials and Methods: </span></b><span style="font-family:Verdana;">Information related to the research subjects were retrieved from a database of patients admitted to King Faisal Specialist Hospital and Research Center hospital in Riyadh, Saudi Arabia between January 2014 and December 2016. Subjects’ confidential information was masked from the investigators. The data analyses were reported visually, descriptively, and analytically using Cox proportional hazard regression model to predict the risk of long-stay when patients’ age and the DRG are considered as antecedent risk factors. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Predicting the risk of long stay depends significantly on the age at admission, and the DRG to which a patient belongs to. We demonstrated the validity of the Cox regression model for the available data as the proportionality assumption is shown to be satisfied. Two examples were presented to demonstrate the utility of the Cox model in this regard.</span></span>
基金Supported by the National Natural Science Foundation of China(No.11171263)
文摘The smooth integration of counting and absolute deviation (SICA) penalized variable selection procedure for high-dimensional linear regression models is proposed by Lv and Fan (2009). In this article, we extend their idea to Cox's proportional hazards (PH) model by using a penalized log partial likelihood with the SICA penalty. The number of the regression coefficients is allowed to grow with the sample size. Based on an approximation to the inverse of the Hessian matrix, the proposed method can be easily carried out with the smoothing quasi-Newton (SQN) algorithm. Under appropriate sparsity conditions, we show that the resulting estimator of the regression coefficients possesses the oracle property. We perform an extensive simulation study to compare our approach with other methods and illustrate it on a well known PBC data for predicting survival from risk factors.
基金Supported by the Gastric Cancer Laboratory and Pathology Department of Chinese Medical University,Shenyang,Chinathe Science and Technology Program of Shenyang,No. 1081232-1-00
文摘AIM:To investigate the efficiency of Cox proportional hazard model in detecting prognostic factors for gastric cancer.METHODS:We used the log-normal regression model to evaluate prognostic factors in gastric cancer and compared it with the Cox model.Three thousand and eighteen gastric cancer patients who received a gastrectomy between 1980 and 2004 were retrospectively evaluated.Clinic-pathological factors were included in a log-normal model as well as Cox model.The akaike information criterion (AIC) was employed to compare the efficiency of both models.Univariate analysis indicated that age at diagnosis,past history,cancer location,distant metastasis status,surgical curative degree,combined other organ resection,Borrmann type,Lauren's classification,pT stage,total dissected nodes and pN stage were prognostic factors in both log-normal and Cox models.RESULTS:In the final multivariate model,age at diagnosis,past history,surgical curative degree,Borrmann type,Lauren's classification,pT stage,and pN stage were significant prognostic factors in both log-normal and Cox models.However,cancer location,distant metastasis status,and histology types were found to be significant prognostic factors in log-normal results alone.According to AIC,the log-normal model performed better than the Cox proportional hazard model (AIC value:2534.72 vs 1693.56).CONCLUSION:It is suggested that the log-normal regression model can be a useful statistical model to evaluate prognostic factors instead of the Cox proportional hazard model.
基金supported by the Aeronautical Science Foundation of China(20155553039)the Natural Sciences and Engineering Research Council of Canada(RGPIN 121384-11)
文摘This paper proposes a health evaluation method for degrading systems subject to competing risks of dependent soft and hard failures. To characterize the time-varying degradation rate, the degradation process is determined by a non-stationary Gamma process and the soft failure is encountered when it exceeds a predefined critical level. For the hard failure, a Cox’s proportional hazard model is applied to describe the hazard rate of the time to system failure. The dependent relationship is modeled by incorporating the degradation process as a time-varying covariate into the Cox’s proportional hazard model. To facilitate the health characteristics evaluation, a discretization technique is applied both to the degradation process and the monitoring time.All health characteristics can be obtained in the explicit form using the transition probability matrix, which is computationally attractive for practical applications. Finally, a numerical analysis is carried out to show the effectiveness and the performance of the proposed health evaluation method.
基金Supported in part by the Central Universities under Grant No.31541311216,2042014kf0256the National Natural Science Foundation of China under Grant No.11171263,11301545,61371126 and 11401443
文摘Generalized case-cohort design has been proved to be a cost-effective way to enhance the efficiency of large epidemiological cohort. In this article, we propose an inference procedure for estimating the unknown parameters in Cox's proportional hazards model in generalized case-cohort design and establish an optimal sample size allocation to achieve the maximum power at a given budget. The finite sample performance of the proposed method is evaluated through simulation studies. The proposed method is applied to a real data set from the National Wilm's Tumor Study Group.
基金The joint fundations of National Natural Science Foundation of China and Civil Aviation Administration of China (60672164)National High-tech Research and Development Program of China (863 Program)(2006AA04Z427)
文摘To reduce engine maintenance cost and support safe operation, a prediction method of engine life on wing was proposed. This method is a kind of regression model which is a function of the condition monitoring and failure data. Key causes of engine removals were analyzed, and the life limit due to performance deterioration was predicted by proportional hazards model. Then the scheduled removal causes were considered as constraints of engine life to predicte the finai life on wing. Application of the proposed prediction method to the case of CF6-80C2A5 engine fleet in an airline proved its effectiveness.
文摘Objective: To evaluate the major prognostic factors in patients with pancreatic carcinoma. Methods:113 cases of a particular disease were retrospectively analysed and 9 factors for prognosis were studied by multivaritate analysis with Cox proportional hazards survival model.Survival rate was calculated by Kaplan-Meier estimation. Results:In this group,survival time was 0.1 to 82 months,and the median survival time was 3 months.Overall survival rates at month 6,12,18,36 were 35.6%,20.3%,15.9% and 6.2%,respectively.Multivariate analyses revealed significant prognostic factors as follows:jaundice,metastasis,therapy method and synthetic therapy. Conclusion: The prognosis of pancreatic carcinoma is determined by various factors.Jaundice and metastasis are independent predictors of poor survival.Radical operation and synthetic therapy will improve the prognosis.
基金supported in part by Natural Science Foundation of Hubei(08BA164)Major Research Program of Hubei Provincial Department of Education(09B2001)+2 种基金supported in part by National Natural Science Foundation of China(1117112)Doctoral Fund of Ministry of Education of China(20090076110001)National Statistical Science Research Major Program of China(2011LZ051)
文摘Recurrent events data and gap times between recurrent events are frequently encountered in many clinical and observational studies,and often more than one type of recurrent events is of interest.In this paper,we consider a proportional hazards model for multiple type recurrent gap times data to assess the effect of covaxiates on the censored event processes of interest.An estimating equation approach is used to obtain the estimators of regression coefficients and baseline cumulative hazard functions.We examine asymptotic properties of the proposed estimators.Finite sample properties of these estimators are demonstrated by simulations.