Covariate Value

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Hapfelmeier Alexander - One of the best experts on this subject based on the ideXlab platform.

  • Confidence interval estimation for the changepoint of treatment stratification in the presence of a qualitative Covariate-treatment interaction
    'Wiley', 2020
    Co-Authors: Haller Bernhard, Mansmann Ulrich, Dobler Dennis, Ulm Kurt, Hapfelmeier Alexander
    Abstract:

    The goal in stratified medicine is to administer the \textquotedblbest\textquotedbl treatment to a patient. Not all patients might benefit from the same treatment; the choice of best treatment can depend on certain patient characteristics. In this article, it is assumed that a time-to-event outcome is considered as a patient-relevant outcome and a qualitative interaction between a continuous Covariate and treatment exists, ie,~that patients with different Values of one specific Covariate should be treated differently. We suggest and investigate different methods for confidence interval estimation for the Covariate Value, where the treatment recommendation should be changed based on data collected in a randomized clinical trial. An adaptation of Fieller's theorem, the delta method, and different bootstrap approaches (normal, percentile-based, wild bootstrap) are investigated and compared in a simulation study. Extensions to multivariable problems are presented and evaluated. We observed appropriate confidence interval coverage following Fieller's theorem irrespective of sample size but at the cost of very wide or even infinite confidence intervals. The delta method and the wild bootstrap approach provided the smallest intervals but inadequate coverage for small to moderate event numbers, also depending on the location of the true changepoint. For the percentile-based bootstrap, wide intervals were observed, and it was slightly conservative regarding coverage, whereas the normal bootstrap did not provide acceptable results for many scenarios. The described methods were also applied to data from a randomized clinical trial comparing two treatments for patients with symptomatic, severe carotid artery stenosis, considering patient's age as predictive marker

  • Confidence interval estimation for the changepoint of treatment stratification in the presence of a qualitative Covariate-treatment interaction
    'Wiley', 2020
    Co-Authors: Haller Bernhard, Mansmann Ulrich, Dobler Dennis, Ulm Kurt, Hapfelmeier Alexander
    Abstract:

    The goal in stratified medicine is to administer the “best” treatment to a patient. Not all patients might benefit from the same treatment; the choice of best treatment can depend on certain patient characteristics. In this article, it is assumed that a time-to-event outcome is considered as a patient-relevant outcome and a qualitative interaction between a continuous Covariate and treatment exists, ie, that patients with different Values of one specific Covariate should be treated differently. We suggest and investigate different methods for confidence interval estimation for the Covariate Value, where the treatment recommendation should be changed based on data collected in a randomized clinical trial. An adaptation of Fieller's theorem, the delta method, and different bootstrap approaches (normal, percentile-based, wild bootstrap) are investigated and compared in a simulation study. Extensions to multivariable problems are presented and evaluated. We observed appropriate confidence interval coverage following Fieller's theorem irrespective of sample size but at the cost of very wide or even infinite confidence intervals. The delta method and the wild bootstrap approach provided the smallest intervals but inadequate coverage for small to moderate event numbers, also depending on the location of the true changepoint. For the percentile-based bootstrap, wide intervals were observed, and it was slightly conservative regarding coverage, whereas the normal bootstrap did not provide acceptable results for many scenarios. The described methods were also applied to data from a randomized clinical trial comparing two treatments for patients with symptomatic, severe carotid artery stenosis, considering patient's age as predictive marker

Christine Jennensteinmetz - One of the best experts on this subject based on the ideXlab platform.

  • sample size determination for studies designed to estimate Covariate dependent reference quantile curves
    Statistics in Medicine, 2014
    Co-Authors: Christine Jennensteinmetz
    Abstract:

    Accuracy and sample size issues concerning the estimation of Covariate-dependent quantile curves are considered. It is proposed to measure the precision of an estimate of the pth quantile at a given Covariate Value by the probability with which this estimate lies between the p1 th and p2 th quantile, where p1  < p < p2 . Requiring that this probability exceeds a given confidence bound for all Covariate Values in a specified range leads to a sample size criterion. Approximate formulae for the precision and sample size are derived for the normal parametric regression approach and for the semiparametric quantile regression method. A simulation study is performed to evaluate the accuracy of the approximations. Numerical evaluations show that rather large numbers of subjects are needed to construct quantile curves with a reasonable amount of accuracy, especially if the quantile regression method is applied.

Ruth King - One of the best experts on this subject based on the ideXlab platform.

  • maximum likelihood estimation of mark recapture recovery models in the presence of continuous Covariates
    The Annals of Applied Statistics, 2013
    Co-Authors: Roland Langrock, Ruth King
    Abstract:

    We consider mark-recapture-recovery (MRR) data of animals where the model parameters are a function of individual time-varying continuous Covariates. For such Covariates, the Covariate Value is unobserved if the corresponding individual is unobserved, in which case the survival probability cannot be evaluated. For continuous-Valued Covariates, the corresponding likelihood can only be expressed in the form of an integral that is analytically intractable, and, to date, no maximum likelihood approach that uses all the information in the data has been developed. Assuming a first-order Markov process for the Covariate Values, we accomplish this task by formulating the MRR setting in a state-space framework and considering an approximate likelihood approach which essentially discretizes the range of Covariate Values, reducing the integral to a summation. The likelihood can then be eciently calculated and maximized using standard techniques for hidden Markov models. We initially assess the approach using simulated data before applying to real data relating to Soay sheep, specifying the survival probability as a function of body mass. Models that have previously been suggested for the corresponding Covariate process are typically of the form of diusive random walks. We consider an alternative non-diusive

  • maximum likelihood estimation of mark recapture recovery models in the presence of continuous Covariates
    arXiv: Methodology, 2012
    Co-Authors: Roland Langrock, Ruth King
    Abstract:

    We consider mark-recapture-recovery (MRR) data of animals where the model parameters are a function of individual time-varying continuous Covariates. For such Covariates, the Covariate Value is unobserved if the corresponding individual is unobserved, in which case the survival probability cannot be evaluated. For continuous-Valued Covariates, the corresponding likelihood can only be expressed in the form of an integral that is analytically intractable and, to date, no maximum likelihood approach that uses all the information in the data has been developed. Assuming a first-order Markov process for the Covariate Values, we accomplish this task by formulating the MRR setting in a state-space framework and considering an approximate likelihood approach which essentially discretizes the range of Covariate Values, reducing the integral to a summation. The likelihood can then be efficiently calculated and maximized using standard techniques for hidden Markov models. We initially assess the approach using simulated data before applying to real data relating to Soay sheep, specifying the survival probability as a function of body mass. Models that have previously been suggested for the corresponding Covariate process are typically of the form of diffusive random walks. We consider an alternative nondiffusive AR(1)-type model which appears to provide a significantly better fit to the Soay sheep data.

Helena C. Kraemer - One of the best experts on this subject based on the ideXlab platform.

  • A Source of False Findings in Published Research Studies: Adjusting for Covariates
    JAMA Psychiatry, 2015
    Co-Authors: Helena C. Kraemer
    Abstract:

    Concern about erroneous conclusions ofmany published research findings has led to the conclusion thatmost published research findings are wrong.1,2 What can be done about that? In what follows, I will focus on one common source of false findings: adjusting for Covariates. Here, adjusting means allowing variables to vary as they will but then using a mathematical model to assess their influenceon theoutcome. In contrast, to controlmeansmanipulation of variables by the researcher for a particular purpose (eg, in experimental design). Unfortunately, the terms adjust and control are often used as if they were synonymous. Adjustingoften leadstofalseconclusionsbecausethemodelsused may not correspond to reality. To illustrate thispoint, consider a randomizedclinical trial (RCT) inwhich those sampled from thepopulation of interest are randomlyassignedto2 treatmentgroups,T1andT2.Avalid test simply comparing the outcomes in the 2 groups tests the overall effect size (overall ES) that a randomly sampled patient from T1 has an outcome clinically preferable to that of a randomly sampled patient from T2.3 Often, the first table of an RCT report compares the baseline characteristics of the T1 vs T2 samples to assess the success of randomization, ignoring the fact that randomization (1) is a process, not an outcome, and (2) ismeant to generate 2 random samples from the same population, not 2 matched samples. When a few baseline variables significantly differentiate the 2 groups at the 5% level, researchers often propose to adjust for those Covariates in testing the treatment effect. This isposthoc testing (likeoffering tobet atpreraceodds on a horse as it approaches the finish line), which frequently leads to false-positive results. Any Covariates to be used in adjusting should be specified apriori, listed in theRCT registration, and taken into consideration in thepower analysis. Suchadjustment changes the hypothesis to be tested from comparing all T1 patients vs all T2 patients (overall ES) to comparing T1 patients onlywith T2 patients matched in one way or another on the particular Covariates proposed. Let’s say that Covariate ES is the ES for patients with one particular configuration of the Covariates and typicalES is theESspecifically forpatientswhoareat themean of each such Covariate (ie, for the typical patient). Overall ES, typical ES, and all possible Covariate ES are the same only if the Covariates are irrelevant to the treatment outcome. If the Covariates are irrelevant, adjusting for those simply leads to a loss of power. If the Covariates arenot irrelevant, then estimation and testing of overall ES, typical ES, and Covariate ESprovide answers to different research questions. The linear model used for Covariate adjusting (eg, analysis of covariance [ANCOVA]) assumes, for all possible Values of the Covariates, that Covariate ES is equal to typical ES; that is, that there is no interaction between the Covariates and the treatment effect. If this assumption is violated, then the interactions that exist in the population (but are not included in the model) can bias the statistical tests and estimation of the treatment ES. Furthermore, not finding statistically significant interactions in the sample does not prove thenull hypothesis that they do not exist in the population. Given these risks for bias, ANCOVA should not generally be used for such adjustment. Whentreatment interactionsare includedina linearmodel, howthevariables are codedcan impact the results.4The treatment effect refers to the treatment effect for patients having thezeroValueofall includedCovariates.Thus, ifT1andT2were 2 treatments for Alzheimer disease, and the single Covariate were chronological age at disease onset, the treatment effect would be the effect of the treatment for individuals with Alzheimer disease diagnosed as having the illness at age 0 years, which is a ludicrous result. Instead, age is better coded as deviations fromthemeanageat onset (centeringat themean). Then the treatment effect is typical ES and the interaction effect reflects the change in Covariate ES as the Covariate Value changes. Examinationof the CovariateESmaywell indicate to clinicianswhichpatientswill respondbetter toT1 orT2.5With multiple Covariates, if each is centered at itsmean,4 the treatment effect tested is typical ES, the treatment effect for those at themeanofeveryCovariate,which is sometimesaverysmall subpopulation. There are still additional problems. For example, when multiple Covariates are included, omitting interactions between them can introduce bias to the estimation of treatment ES. However, to include all interactions involving m Covariates in a linear model requires estimation of 2m +1 parameters. To make matters even worse, the advantage of an RCT with random assignment is that, over replications, treatment choice and each Covariate are uncorrelated. However, Covariates may be correlated with each other (collinearity). Correlated variables share information. In fitting a model to the data, the computer is instructed to allocate the information shared between 2 variables to one variable or the other. The computer does this using information from within the sample. Because such information will change from one sample to another, the estimates of the adjusted treatment effects (typical ES and Covariate ES) are unstable and difficult to replicate. Opinion

Haller Bernhard - One of the best experts on this subject based on the ideXlab platform.

  • Confidence interval estimation for the changepoint of treatment stratification in the presence of a qualitative Covariate-treatment interaction
    'Wiley', 2020
    Co-Authors: Haller Bernhard, Mansmann Ulrich, Dobler Dennis, Ulm Kurt, Hapfelmeier Alexander
    Abstract:

    The goal in stratified medicine is to administer the \textquotedblbest\textquotedbl treatment to a patient. Not all patients might benefit from the same treatment; the choice of best treatment can depend on certain patient characteristics. In this article, it is assumed that a time-to-event outcome is considered as a patient-relevant outcome and a qualitative interaction between a continuous Covariate and treatment exists, ie,~that patients with different Values of one specific Covariate should be treated differently. We suggest and investigate different methods for confidence interval estimation for the Covariate Value, where the treatment recommendation should be changed based on data collected in a randomized clinical trial. An adaptation of Fieller's theorem, the delta method, and different bootstrap approaches (normal, percentile-based, wild bootstrap) are investigated and compared in a simulation study. Extensions to multivariable problems are presented and evaluated. We observed appropriate confidence interval coverage following Fieller's theorem irrespective of sample size but at the cost of very wide or even infinite confidence intervals. The delta method and the wild bootstrap approach provided the smallest intervals but inadequate coverage for small to moderate event numbers, also depending on the location of the true changepoint. For the percentile-based bootstrap, wide intervals were observed, and it was slightly conservative regarding coverage, whereas the normal bootstrap did not provide acceptable results for many scenarios. The described methods were also applied to data from a randomized clinical trial comparing two treatments for patients with symptomatic, severe carotid artery stenosis, considering patient's age as predictive marker

  • Confidence interval estimation for the changepoint of treatment stratification in the presence of a qualitative Covariate-treatment interaction
    'Wiley', 2020
    Co-Authors: Haller Bernhard, Mansmann Ulrich, Dobler Dennis, Ulm Kurt, Hapfelmeier Alexander
    Abstract:

    The goal in stratified medicine is to administer the “best” treatment to a patient. Not all patients might benefit from the same treatment; the choice of best treatment can depend on certain patient characteristics. In this article, it is assumed that a time-to-event outcome is considered as a patient-relevant outcome and a qualitative interaction between a continuous Covariate and treatment exists, ie, that patients with different Values of one specific Covariate should be treated differently. We suggest and investigate different methods for confidence interval estimation for the Covariate Value, where the treatment recommendation should be changed based on data collected in a randomized clinical trial. An adaptation of Fieller's theorem, the delta method, and different bootstrap approaches (normal, percentile-based, wild bootstrap) are investigated and compared in a simulation study. Extensions to multivariable problems are presented and evaluated. We observed appropriate confidence interval coverage following Fieller's theorem irrespective of sample size but at the cost of very wide or even infinite confidence intervals. The delta method and the wild bootstrap approach provided the smallest intervals but inadequate coverage for small to moderate event numbers, also depending on the location of the true changepoint. For the percentile-based bootstrap, wide intervals were observed, and it was slightly conservative regarding coverage, whereas the normal bootstrap did not provide acceptable results for many scenarios. The described methods were also applied to data from a randomized clinical trial comparing two treatments for patients with symptomatic, severe carotid artery stenosis, considering patient's age as predictive marker