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Non‐parametric estimation of the case fatality ratio with competing risks data: an application to Severe Acute Respiratory Syndrome (SARS)

Identifieur interne : 001092 ( Pmc/Checkpoint ); précédent : 001091; suivant : 001093

Non‐parametric estimation of the case fatality ratio with competing risks data: an application to Severe Acute Respiratory Syndrome (SARS)

Auteurs : Nicholas P. Jewell ; Xiudong Lei ; Azra C. Ghani ; Christl A. Donnelly ; Gabriel M. Leung ; Lai-Ming Ho ; Benjamin J. Cowling ; Anthony J. Hedley

Source :

RBID : PMC:7169492

Abstract

Abstract

For diseases with some level of associated mortality, the case fatality ratio measures the proportion of diseased individuals who die from the disease. In principle, it is straightforward to estimate this quantity from individual follow‐up data that provides times from onset to death or recovery. In particular, in a competing risks context, the case fatality ratio is defined by the limiting value of the sub‐distribution function, F1(t) = Pr(Tt and J = 1), associated with death, as t → ∞, where T denotes the time from onset to death (J = 1) or recovery (J = 2). When censoring is present, however, estimation of F1(∞) is complicated by the possibility of little information regarding the right tail of F1, requiring use of estimators of F1(t*) or F1(t*)/(F1(t*)+F2(t*)) where t* is large, with F2(t) = Pr(Tt and J = 2) being the analogous sub‐distribution function associated with recovery. With right censored data, the variability of such estimators increases as t* increases, suggesting the possibility of using estimators at lower values of t* where bias may be increased but overall mean squared error be smaller. These issues are investigated here for non‐parametric estimators of F1 and F2. The ideas are illustrated on case fatality data for individuals infected with Severe Acute Respiratory Syndrome (SARS) in Hong Kong in 2003. Copyright © 2006 John Wiley & Sons, Ltd.


Url:
DOI: 10.1002/sim.2691
PubMed: NONE
PubMed Central: 7169492


Affiliations:


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PMC:7169492

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<article-title>Non‐parametric estimation of the case fatality ratio with competing risks data: an application to Severe Acute Respiratory Syndrome (SARS)</article-title>
<alt-title alt-title-type="right-running-head">NON‐PARAMETRIC ESTIMATION OF CFR</alt-title>
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<contrib id="au1" contrib-type="author" corresp="yes">
<name>
<surname>Jewell</surname>
<given-names>Nicholas P.</given-names>
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<xref ref-type="aff" rid="af1">
<sup>1</sup>
</xref>
<address>
<email>jewell@stat.berkeley.edu</email>
</address>
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<contrib id="au2" contrib-type="author">
<name>
<surname>Lei</surname>
<given-names>Xiudong</given-names>
</name>
<address>
<email>xiudonglei@hotmail.com</email>
</address>
<xref ref-type="aff" rid="af1">
<sup>1</sup>
</xref>
</contrib>
<contrib id="au3" contrib-type="author">
<name>
<surname>Ghani</surname>
<given-names>Azra C.</given-names>
</name>
<address>
<email>azra.ghani@lshtm.ac.uk</email>
</address>
<xref ref-type="aff" rid="af2">
<sup>2</sup>
</xref>
</contrib>
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<name>
<surname>Donnelly</surname>
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<sup>2</sup>
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<name>
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<given-names>Gabriel M.</given-names>
</name>
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<email>gmleung@hku.hk</email>
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<sup>3</sup>
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<sup>3</sup>
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<given-names>Anthony J.</given-names>
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<email>hrmrajh@hkucc.hku.hk</email>
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<label>
<sup>1</sup>
</label>
Division of Biostatistics and Department of Statistics, University of California, Berkeley, U.S.A.</aff>
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<sup>2</sup>
</label>
Department of Infectious Disease Epidemiology, Imperial College, London, U.K.</aff>
<aff id="af3">
<label>
<sup>3</sup>
</label>
Department of Community Medicine, University of Hong Kong, Hong Kong</aff>
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<corresp id="correspondenceTo">
<label>*</label>
Division of Biostatistics and Department of Statistics, University of California, Berkeley, U.S.A.</corresp>
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<fpage>1982</fpage>
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<abstract>
<title>Abstract</title>
<p>For diseases with some level of associated mortality, the case fatality ratio measures the proportion of diseased individuals who die from the disease. In principle, it is straightforward to estimate this quantity from individual follow‐up data that provides times from onset to death or recovery. In particular, in a competing risks context, the case fatality ratio is defined by the limiting value of the sub‐distribution function,
<italic>F</italic>
<sub>1</sub>
(
<italic>t</italic>
) = Pr(
<italic>T</italic>
<italic>t</italic>
and
<italic>J</italic>
= 1), associated with death, as
<italic>t</italic>
→ ∞, where
<italic>T</italic>
denotes the time from onset to death (
<italic>J</italic>
= 1) or recovery (
<italic>J</italic>
= 2). When censoring is present, however, estimation of
<italic>F</italic>
<sub>1</sub>
(∞) is complicated by the possibility of little information regarding the right tail of
<italic>F</italic>
<sub>1</sub>
, requiring use of estimators of
<italic>F</italic>
<sub>1</sub>
(t
<sup>*</sup>
) or
<italic>F</italic>
<sub>1</sub>
(
<italic>t</italic>
<sup>*</sup>
)/(
<italic>F</italic>
<sub>1</sub>
(
<italic>t</italic>
<sup>*</sup>
)+
<italic>F</italic>
<sub>2</sub>
(
<italic>t</italic>
<sup>*</sup>
)) where
<italic>t</italic>
<sup>*</sup>
is large, with
<italic>F</italic>
<sub>2</sub>
(
<italic>t</italic>
) = Pr(
<italic>T</italic>
<italic>t</italic>
and
<italic>J</italic>
= 2) being the analogous sub‐distribution function associated with recovery. With right censored data, the variability of such estimators increases as
<italic>t</italic>
<sup>*</sup>
increases, suggesting the possibility of using estimators at lower values of
<italic>t</italic>
<sup>*</sup>
where bias may be increased but overall mean squared error be smaller. These issues are investigated here for non‐parametric estimators of
<italic>F</italic>
<sub>1</sub>
and
<italic>F</italic>
<sub>2</sub>
. The ideas are illustrated on case fatality data for individuals infected with Severe Acute Respiratory Syndrome (SARS) in Hong Kong in 2003. Copyright © 2006 John Wiley & Sons, Ltd.</p>
</abstract>
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<name sortKey="Hedley, Anthony J" sort="Hedley, Anthony J" uniqKey="Hedley A" first="Anthony J." last="Hedley">Anthony J. Hedley</name>
<name sortKey="Ho, Lai Ing" sort="Ho, Lai Ing" uniqKey="Ho L" first="Lai-Ming" last="Ho">Lai-Ming Ho</name>
<name sortKey="Jewell, Nicholas P" sort="Jewell, Nicholas P" uniqKey="Jewell N" first="Nicholas P." last="Jewell">Nicholas P. Jewell</name>
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