Choice of baseline hazards in joint modeling of longitudinal and time-to-event cancer survival data.

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Longitudinal time-to-event analysis is a statistical method to analyze data where covariates are measured repeatedly. In survival studies, the risk for an event is estimated using Cox-proportional hazard model or extended Cox-model for exogenous time-dependent covariates. However, these models are inappropriate for endogenous time-dependent covariates like longitudinally measured biomarkers, Carcinoembryonic Antigen (CEA). Joint models that can simultaneously model the longitudinal covariates and time-to-event data have been proposed as an alternative. The present study highlights the importance of choosing the baseline hazards to get more accurate risk estimation. The study used colon cancer patient data to illustrate and compare four different joint models which differs based on the choice of baseline hazards [piecewise-constant Gauss-Hermite (GH), piecewise-constant pseudo-adaptive GH, Weibull Accelerated Failure time model with GH & B-spline GH]. We conducted simulation study to assess the model consistency with varying sample size (N = 100, 250, 500) and censoring (20 %, 50 %, 70 %) proportions. In colon cancer patient data, based on Akaike information criteria (AIC) and Bayesian information criteria (BIC), piecewise-constant pseudo-adaptive GH was found to be the best fitted model. Despite differences in model fit, the hazards obtained from the four models were similar. The study identified composite stage as a prognostic factor for time-to-event and the longitudinal outcome, CEA as a dynamic predictor for overall survival in colon cancer patients. Based on the simulation study Piecewise-PH-aGH was found to be the best model with least AIC and BIC values, and highest coverage probability(CP). While the Bias, and RMSE for all the models showed a competitive performance. However, Piecewise-PH-aGH has shown least bias and RMSE in most of the combinations and has taken the shortest computation time, which shows its computational efficiency. This study is the first of its kind to discuss on the choice of baseline hazards.

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The objective of this study is to determine the significant predictors of endometrial cancer using accelerated failure time models (AFTM). We have demonstrated the applications of AFTM viz. Exponential, Weibull, Log-normal, Log-logistic, Gompertz, Gamma and Generalized Gamma AFTM, as an alternative of Cox proportional hazard model. Data for the analysis was collected from Acharya Harihar Post Graduate Institute of Cancer (AHPGIC), Cuttack, Odisha during the period 2016–20. Based on the lowest Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) value, the Weibull AFTM has been chosen as the best fitted AFT model. The predictors such as age, comorbidity, tumor size, isolated para-aortic and adnexa have been found as significant predictors (p-value < 0.05) to explain the survival of endometrial cancer patients. Hence, by optimizing different treatments, based on such prognostic factors plays an important role in managing endometrial cancer at an early stage.

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  • Journal of Gastrointestinal Oncology
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Kenya is one of the countries in the world with a good quantity of wind. This makes the country to work on technologies that can help in harnessing the wind with a vision of achieving a total capacity of 2GW of wind energy by 2030. The objective of this research is to find the best three-parameter wind speed distribution for examining wind speed using the maximum likelihood fitting technique. To achieve the objective, the study used hourly wind speed data collected for a period of three years (2016 – 2018) from five sites within Narok County. The study examines the best distributions that the data fits and then conducted a suitability test of the distributions using the Kolmogorov-Smirnov test. The distribution parameters were fitted using maximum likelihood technique and model comparison test conducted using Akaike’s Information Criterion (AIC) and the Bayesian Information Criterion (BIC) values with the decision rule that the best distribution relies on the distribution with the smaller AIC and BIC values. The research showed that the best distribution is the gamma distribution with the shape parameter of 2.071773, scale parameter of 1.120855, and threshold parameter of 0.1174. A conclusion that gamma distribution is the best three-parameter distribution for examining the Narok country wind speed data.

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  • Book Chapter
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Assessment of Fit in Longitudinal Data for Joint Models with Applications to Cancer Clinical Trials
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Joint models for longitudinal and survival data have now become increasingly popular in clinical trials or other studies for assessing a treatment effect while accounting for longitudinal measures such as patient-reported outcomes or tumor response. Most studies in the existing literature primarily focus on reducing the bias and improving efficiency in the estimate of the treatment effect in the joint modeling of survival and longitudinal data. Global fit indices such as Akaike information criterion (AIC) or Bayesian information criterion (BIC) can be used to assess the overall fit of the joint model. However, these indices do not provide separate assessments of each component of the joint model. In this chapter, we develop new model assessment criteria using a novel decomposition of AIC and BIC (i.e., AIC = AIC\(_\textrm{Surv}\) + AIC\(_\textrm{Long} | \textrm{Surv}\) and BIC = BIC\(_\textrm{Surv}\) + BIC\(_\textrm{Long} | \textrm{Surv}\)) to assess the contribution of the survival data to the model fit of the longitudinal data. We apply the proposed methodology to the analysis of a real dataset from a cancer clinical trial in mesothelioma.

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