Gaining more flexibility in Cox proportional hazards regression models with cubic spline functions

1997 ◽  
Vol 54 (3) ◽  
pp. 201-208 ◽  
Author(s):  
Harald Heinzl ◽  
Alexandra Kaider
Keyword(s):  
Regression Models ◽  
Proportional Hazards ◽  
Cubic Spline ◽  
Cox Proportional Hazards ◽  
Spline Functions ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression

scholarly journals Prognostic impact of a lymphocyte activation-associated gene signature in GBM based on transcriptome analysis

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12070
Author(s):  
Yujia Lan ◽  
Erjie Zhao ◽  
Xinxin Zhang ◽  
Xiaojing Zhu ◽  
Linyun Wan ◽  
...  
Keyword(s):  
Regression Models ◽  
Proportional Hazards ◽  
Lymphocyte Activation ◽  
Risk Groups ◽  
Gene Signature ◽  
Cox Proportional Hazards ◽  
Low Risk ◽  
Training Dataset ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression

Background Glioblastoma multiforme (GBM) is a highly, malignant tumor of the primary central nervous system. Patients diagnosed with this type of tumor have a poor prognosis. Lymphocyte activation plays important roles in the development of cancers and its therapeutic treatments. Objective We sought to identify an efficient lymphocyte activation-associated gene signature that could predict the progression and prognosis of GBM. Methods We used univariate Cox proportional hazards regression and stepwise regression algorithm to develop a lymphocyte activation-associated gene signature in the training dataset (TCGA, n = 525). Then, the signature was validated in two datasets, including GSE16011 (n = 150) and GSE13041 (n = 191) using the Kaplan Meier method. Univariate and multivariate Cox proportional hazards regression models were used to adjust for clinicopathological factors. Results We identified a lymphocyte activation-associated gene signature (TCF3, IGFBP2, TYRO3 and NOD2) in the training dataset and classified the patients into high-risk and low-risk groups with significant differences in overall survival (median survival 15.33 months vs 12.57 months, HR = 1.55, 95% CI [1.28–1.87], log-rank test P < 0.001). This signature showed similar prognostic values in the other two datasets. Further, univariate and multivariate Cox proportional hazards regression models analysis indicated that the signature was an independent prognostic factor for GBM patients. Moreover, we determined that there were differences in lymphocyte activity between the high- and low-risk groups of GBM patients among all datasets. Furthermore, the lymphocyte activation-associated gene signature could significantly predict the survival of patients with certain features, including IDH-wildtype patients and patients undergoing radiotherapy. In addition, the signature may also improve the prognostic power of age. Conclusions In summary, our results suggested that the lymphocyte activation-associated gene signature is a promising factor for the survival of patients, which is helpful for the prognosis of GBM patients.

MO509DOSE-RESPONSE RELATIONSHIP BETWEEN ALCOHOL CONSUMPTION AND THE RISK OF DEVELOPING CKD: RETROSPECTIVE COHORT STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Yusaku Hashimoto ◽  
Takahiro Imaizumi ◽  
Akihiro Hori ◽  
Sawako Kato ◽  
Yoshinari Yasuda ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Dose Response ◽  
Regression Models ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Response Relationship ◽  
Dose Response Relationship ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Incidence Of Ckd

Abstract Background and Aims Drinking habits are one of the most important modifiable lifestyle factors to prevent the development of chronic kidney disease (CKD). Previous studies showed that it was inversely associated with the risk of developing CKD, but the dose-response relationship between alcohol consumption and the development of CKD is still controversial. In the present study, we aimed to examine whether the amount of alcohol consumed at one time is associated with new onset of CKD in general population. Method Study subjects were 11,162 Japanese aged 45 to 74 years, with an estimated glomerular filtration rate ≥60 mL/min/1.73m2, no proteinuria, no past history of cardiovascular disease, COPD or liver disease. The drinking status was obtained by self-administered questionnaires. We categorized the study subjects into four groups based on the amount of alcohol consumption: &lt;20g/time of ethanol equivalent (lowest); 20-40g/time (low intermediate); 40-60g/time (high intermediate); &gt;60g/time (highest). We set non-drinkers as a reference category. The primary outcome was the incidence of CKD, defined as 25% reduction of eGFR and to less than 60 mL/min/1.73 m2 and/or a dipstick urinalysis score of 1+ or greater (equivalent to ≥30 mg/dL) during the follow up period. We employed Cox proportional hazards regression models to examine the dose-response relationship between baseline alcohol consumption and the risk of CKD. Trend tests were performed using Cox proportional hazards regression models that treated alcohol consumption as a continuous linear term. Results Lowest and low intermediate groups were significantly associated with a decreased risk of CKD (hazard ratio [HR] 0.84; 95% confidence interval [CI], and 0.71–0.99; HR 0.79; 95% CI, 0.66–0.96, respectively) compared to non-drinkers. High intermediate group was associated with a decreased risk of CKD (HR 0.92; 95% CI, 0.70–1.21), and highest group was associated with an increased risk of CKD (HR 1.28; 95% CI, 0.84–1.95), but these associations did not reach statistical significance. There was no dose-response relationship between baseline alcohol consumption and risk of CKD (P-trend = 0.30). Conclusion A J-shape association was observed between self-reported alcohol intake and the incidence of CKD. Moderate alcohol consumption at one time may help reduce the risk of CKD.

scholarly journals Quantitative assessment of erector spinae muscles and prognosis in elderly patients with pneumonia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hiroki Yoshikawa ◽  
Kosaku Komiya ◽  
Takashi Yamamoto ◽  
Naoko Fujita ◽  
Hiroaki Oka ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Hospital Mortality ◽  
Regression Models ◽  
Proportional Hazards ◽  
Community Acquired Pneumonia ◽  
Cox Proportional Hazards ◽  
Erector Spinae ◽  
Cross Sectional ◽  
Proportional Hazards Regression ◽  
Survivor Group

AbstractErector spinae muscle (ESM) size has been reported as a predictor of prognosis in patients with some respiratory diseases. This study aimed to assess the association of ESM size on all-cause in-hospital mortality among elderly patients with pneumonia. We retrospectively included patients (age: ≥ 65 years) admitted to hospital from January 2015 to December 2017 for community-acquired pneumonia who underwent chest computed tomography (CT) on admission. The cross-sectional area of the ESM (ESMcsa) was measured on a single-slice CT image at the end of the 12th thoracic vertebra and adjusted by body surface area (BSA). Cox proportional hazards regression models were used to assess the influence of ESMcsa/BSA on in-hospital mortality. Among 736 patients who were admitted for pneumonia, 702 patients (95%) underwent chest CT. Of those, 689 patients (98%) for whom height and weight were measured to calculate BSA were included in this study. Patients in the non-survivor group were significantly older, had a greater frequency of respiratory failure, loss of consciousness, lower body mass index, hemoglobin, albumin, and ESMcsa/BSA. Multivariate analysis showed that a lower ESMcsa/BSA independently predicted in-hospital mortality after adjusting for these variables. In elderly patients with pneumonia, quantification of ESMcsa/BSA may be associated with in-hospital mortality.

scholarly journals Replacement of potatoes with other vegetables and risk of myocardial infarction in the Danish Diet, Cancer and Health cohort

2021 ◽  
pp. 1-21
Author(s):  
Anne Mette L. Würtz ◽  
Mette D. Hansen ◽  
Anne Tjønneland ◽  
Eric B. Rimm ◽  
Erik B. Schmidt ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Similar Pattern ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Heterogeneous Group ◽  
Dietary Guidelines ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Root Vegetables

ABSTRACT Intake of vegetables is recommended for the prevention of myocardial infarction (MI). However, vegetables make up a heterogeneous group, and subgroups of vegetables may be differentially associated with MI. The aim of this study was to examine replacement of potatoes with other vegetables or subgroups of other vegetables and the risk of MI. Substitutions between subgroups of other vegetables and risk of MI were also investigated. We followed 29,142 women and 26,029 men aged 50-64 years in the Danish Diet, Cancer and Health cohort. Diet was assessed at baseline by using a detailed validated FFQ. Hazards ratios (HR) with 95% CI for the incidence of MI were calculated using Cox proportional hazards regression. During 13.6 years of follow-up, 656 female and 1,694 male cases were identified. Among women, the adjusted HR for MI was 1.02 (95% CI: 0.93, 1.13) per 500 g/week replacement of potatoes with other vegetables. For vegetable subgroups, the HR was 0.93 (95% CI: 0.77, 1.13) for replacement of potatoes with fruiting vegetables and 0.91 (95% CI: 0.77, 1.07) for replacement of potatoes with other root vegetables. A higher intake of cabbage replacing other vegetable subgroups was associated with a statistically non-significant higher risk of MI. A similar pattern of associations was found when intake was expressed in kcal/week. Among men, the pattern of associations was overall found to be similar to that for women. This study supports food-based dietary guidelines recommending to consume a variety of vegetables from all subgroups.

Development and Validation of a Prognostic Nomogram Model for Recurrence of Non-Muscle Invasive Bladder Cancer

2021 ◽  
Author(s):  
Sanhe Liu ◽  
Yongzhi Li ◽  
Diansheng Cui ◽  
Yuexia Jiao ◽  
Liqun Duan ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Risk Stratification ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Muscle Invasive Bladder Cancer ◽  
Clinicopathologic Characteristics ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Muscle Invasive

Abstract BackgroundDifferent recurrence probability of non-muscle invasive bladder cancer (NMIBC) requests different adjuvant treatments and follow-up strategies. However, there is no simple, intuitive, and generally accepted clinical recurrence predictive model available for NMIBC. This study aims to construct a predictive model for the recurrence of NMIBC based on demographics and clinicopathologic characteristics from two independent centers. MethodsDemographics and clinicopathologic characteristics of 511 patients with NMIBC were retrospectively collected. Recurrence free survival (RFS) was estimated using the Kaplan-Meier method and log-rank tests. Univariate Cox proportional hazards regression analysis was used to screen variables associated with RFS, and a multivariate Cox proportional hazards regression model with a stepwise procedure was used to identify those factors of significance. A final nomogram model was built using the multivariable Cox method. The performance of the nomogram model was evaluated with respect to its calibration, discrimination, and clinical usefulness. Internal validation was assessed with bootstrap resampling. X-tile software was used for risk stratification calculated by the nomogram model. ResultsIndependent prognostic factors including tumor stage, recurrence status, and European Association of Urology (EAU) risk stratification group were introduced to the nomogram model. The model showed acceptable calibration and discrimination (area under the receiver operating characteristic [ROC] curve was 0.85; the consistency index [C-index] was 0.79 [95% CI: 0.76 to 0.82]), which was superior to the EAU risk stratification group alone. The decision curve also proved well clinical usefulness. Moreover, all populations could be stratified into three distinct risk groups by the nomogram model. ConclusionsWe established and validated a novel nomogram model that can provide individual prediction of RFS for patients with NMIBC. This intuitively prognostic nomogram model may help clinicians in postoperative treatment and follow-up decision-making.

Antibiotic and acid-suppression medications during early childhood are associated with obesity

Gut ◽  
2018 ◽  
Vol 68 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Christopher M Stark ◽  
Apryl Susi ◽  
Jill Emerick ◽  
Cade M Nylund
Keyword(s):  
Early Childhood ◽  
Department Of Defense ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Event Analysis ◽  
Early Exposure ◽  
Single Event ◽  
Inclusion Criteria ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression

ObjectiveGut microbiota alterations are associated with obesity. Early exposure to medications, including acid suppressants and antibiotics, can alter gut biota and may increase the likelihood of developing obesity. We investigated the association of antibiotic, histamine-2 receptor antagonist (H2RA) and proton pump inhibitor (PPI) prescriptions during early childhood with a diagnosis of obesity.DesignWe performed a cohort study of US Department of Defense TRICARE beneficiaries born from October 2006 to September 2013. Exposures were defined as having any dispensed prescription for antibiotic, H2RA or PPI medications in the first 2 years of life. A single event analysis of obesity was performed using Cox proportional hazards regression.Results333 353 children met inclusion criteria, with 241 502 (72.4%) children prescribed an antibiotic, 39 488 (11.8%) an H2RA and 11 089 (3.3%) a PPI. Antibiotic prescriptions were associated with obesity (HR 1.26; 95% CI 1.23 to 1.28). This association persisted regardless of antibiotic class and strengthened with each additional class of antibiotic prescribed. H2RA and PPI prescriptions were also associated with obesity, with a stronger association for each 30-day supply prescribed. The HR increased commensurately with exposure to each additional medication group prescribed.ConclusionsAntibiotics, acid suppressants and the combination of multiple medications in the first 2 years of life are associated with a diagnosis of childhood obesity. Microbiota-altering medications administered in early childhood may influence weight gain.

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