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The ratio of the hazard functions of two populations or two strata of a single population plays an important role in time-to-event analysis. Cox regression is commonly used to estimate the hazard ratio under the assumption that it is constant in time, which is known as the proportional hazards assumption. However, this assumption is often violated in practice, and when it is violated, the parameter estimated by Cox regression is difficult to interpret. The hazard ratio can be estimated in a nonparametric manner using smoothing, but smoothing-based estimators are sensitive to the selection of tuning parameters, and it is often difficult to perform valid inference with such estimators. In some cases, it is known that the hazard ratio function is monotone. In this article, we demonstrate that monotonicity of the hazard ratio function defines an invariant stochastic order, and we study the properties of this order. Furthermore, we introduce an estimator of the hazard ratio function under a monotonicity constraint. We demonstrate that our estimator converges in distribution to a mean-zero limit, and we use this result to construct asymptotically valid confidence intervals. Finally, we conduct numerical studies to assess the finite-sample behavior of our estimator, and we use our methods to estimate the hazard ratio of progression-free survival in pulmonary adenocarcinoma patients treated with gefitinib or carboplatin-paclitaxel.
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Semiparametric Estimation of the Accelerated Mean Model with Panel Count Data Under Informative Examination Times
Summary Panel count data arise when the number of recurrent events experienced by each subject is observed intermittently at discrete examination times. The examination time process can be informative about the underlying recurrent event process even after conditioning on covariates. We consider a semiparametric accelerated mean model for the recurrent event process and allow the two processes to be correlated through a shared frailty. The regression parameters have a simple marginal interpretation of modifying the time scale of the cumulative mean function of the event process. A novel estimation procedure for the regression parameters and the baseline rate function is proposed based on a conditioning technique. In contrast to existing methods, the proposed method is robust in the sense that it requires neither the strong Poisson-type assumption for the underlying recurrent event process nor a parametric assumption on the distribution of the unobserved frailty. Moreover, the distribution of the examination time process is left unspecified, allowing for arbitrary dependence between the two processes. Asymptotic consistency of the estimator is established, and the variance of the estimator is estimated by a model-based smoothed bootstrap procedure. Numerical studies demonstrated that the proposed point estimator and variance estimator perform well with practical sample sizes. The methods are applied to data from a skin cancer chemoprevention trial.
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- Award ID(s):
- 1659328
- PAR ID:
- 10485820
- Publisher / Repository:
- Oxford University Press
- Date Published:
- Journal Name:
- Biometrics
- Volume:
- 74
- Issue:
- 3
- ISSN:
- 0006-341X
- Format(s):
- Medium: X Size: p. 944-953
- Size(s):
- p. 944-953
- Sponsoring Org:
- National Science Foundation
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