scholarly journals Proposals on Kaplan–Meier plots in medical research and a survey of stakeholder views: KMunicate

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030215 ◽  
Author(s):  
Tim P Morris ◽  
Christopher I Jarvis ◽  
William Cragg ◽  
Patrick P J Phillips ◽  
Babak Choodari-Oskooei ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Event Data ◽  
Time To Event ◽  
Web Based ◽  
Time To Event Data ◽  
Kaplan Meier ◽  
Starting Point ◽  
Wide Range ◽  
International Participation ◽  
Over Time

ObjectivesTo examine reactions to the proposed improvements to standard Kaplan–Meier plots, the standard way to present time-to-event data, and to understand which (if any) facilitated better depiction of (1) the state of patients over time, and (2) uncertainty over time in the estimates of survival.DesignA survey of stakeholders’ opinions on the proposals.SettingA web-based survey, open to international participation, for those with an interest in visualisation of time-to-event data.Participants1174 people participated in the survey over a 6-week period. Participation was global (although primarily Europe and North America) and represented a wide range of researchers (primarily statisticians and clinicians).Main outcome measuresTwo outcome measures were of principal importance: (1) participants’ opinions of each proposal compared with a ‘standard’ Kaplan–Meier plot; and (2) participants’ overall ranking of the proposals (including the standard).ResultsMost proposals were more popular than the standard Kaplan–Meier plot. The most popular proposals in the two categories, respectively, were an extended table beneath the plot depicting the numbers at risk, censored and having experienced an event at periodic timepoints, and CIs around each Kaplan–Meier curve.ConclusionsThis study produced a high response number, reflecting the importance of graphics for time-to-event data. Those producing and publishing Kaplan–Meier plots—both authors and journals—should, as a starting point, consider using the combination of the two favoured proposals.

scholarly journals Joint modelling of longitudinal and time-to-event data: An illustration using CD4 count and mortality in a cohort of patients initiated on antiretroviral therapy

2020 ◽  
Author(s):  
Nobuhle Nokubonga Mchunu ◽  
Henry Mwambi ◽  
Tarylee Reddy ◽  
Nonhlanhla Yende-Zuma ◽  
Kogieleum Naidoo
Keyword(s):  
Cox Model ◽  
Joint Model ◽  
Cd4 Count ◽  
Time Varying ◽  
Event Data ◽  
Time To Event ◽  
Joint Modelling ◽  
Risk Of Death ◽  
Time To Event Data ◽  
Over Time

Abstract Background: Modelling of longitudinal biomarkers and time-to-event data are important to monitor disease progression. However, these two variables are traditionally analyzed separately or time-varying Cox models are used. The former strategy fails to recognize the shared random-effects from the two processes while the latter assumes that longitudinal biomarkers are exogenous covariates, resulting in inefficient or biased estimates for the time-to-event model. Therefore, we used joint modelling for longitudinal and time-to-event data to assess the effect of longitudinal CD4 count on mortality. Methods: We studied 4014 patients from the Centre for the AIDS Programme of Research in South Africa (CAPRISA) who initiated ART between June 2004 and August 2013. We used proportional hazards regression model to assess the effect of baseline characteristics (excluding CD4 count) on mortality, and linear mixed effect models to evaluate the effect of baseline characteristics on the CD4 count evolution over time. Thereafter, the two analytical approaches were amalgamated to form an advanced joint model for studying the effect of longitudinal CD4 count on mortality. To illustrate the virtues of the joint model, the results from the joint model were compared to those from the time-varying Cox model. Results: Using joint modelling, we found that lower CD4 count over time was associated with a 1.3-fold increase in the risk of death, (HR: 1.34, 95% CI: 1.27-1.42). Whereas, results from the time-varying Cox model showed lower CD4 count over time was associated with a 1.2-fold increase in the risk of death, (HR: 1.17, 95% CI: 1.12-1.23). Conclusions: Joint modelling enabled the assessment of the effect of longitudinal CD4 count on mortality while correcting for shared random effects between longitudinal and time-to-event models. In the era of universal test and treat, the evaluation of CD4 count is still crucial for guiding the initiation and discontinuation of opportunistic infections prophylaxis and assessment of late presenting patients. CD4 count can also be used when immunological failure is suspected as we have shown that it is associated with mortality. Keywords: Time-to-event data; longitudinal data; joint models; CD4 count; mortality; bias

scholarly journals GAC: Gene Associations with Clinical, a web based application

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1039
Author(s):  
Xinyan Zhang ◽  
Manali Rupji ◽  
Jeanne Kowalski
Keyword(s):  
High Dimensional Data ◽  
Interactive Visualization ◽  
High Dimensional ◽  
Forest Plot ◽  
Event Data ◽  
Time To Event ◽  
Web Based ◽  
Link Type ◽  
Time To Event Data ◽  
Clinical Associations

We present GAC, a shiny R based tool for interactive visualization of clinical associations based on high-dimensional data. The tool provides a web-based suite to perform supervised principal component analysis (SuperPC), an approach that uses both high-dimensional data, such as gene expression, combined with clinical data to infer clinical associations. We extended the approach to address binary outcomes, in addition to continuous and time-to-event data in our package, thereby increasing the use and flexibility of SuperPC.  Additionally, the tool provides an interactive visualization for summarizing results based on a forest plot for both binary and time-to-event data.  In summary, the GAC suite of tools provide a one stop shop for conducting statistical analysis to identify and visualize the association between a clinical outcome of interest and high-dimensional data types, such as genomic data. Our GAC package has been implemented in R and is available via http://shinygispa.winship.emory.edu/GAC/. The developmental repository is available at https://github.com/manalirupji/GAC.

scholarly journals GAC: Gene Associations with Clinical, a web based application

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1039
Author(s):  
Xinyan Zhang ◽  
Manali Rupji ◽  
Jeanne Kowalski
Keyword(s):  
High Dimensional Data ◽  
Interactive Visualization ◽  
High Dimensional ◽  
Forest Plot ◽  
Event Data ◽  
Time To Event ◽  
Web Based ◽  
Link Type ◽  
Time To Event Data ◽  
Clinical Associations

We present GAC, a shiny R based tool for interactive visualization of clinical associations based on high-dimensional data. The tool provides a web-based suite to perform supervised principal component analysis (SuperPC), an approach that uses both high-dimensional data, such as gene expression, combined with clinical data to infer clinical associations. We extended the approach to address binary outcomes, in addition to continuous and time-to-event data in our package, thereby increasing the use and flexibility of SuperPC.  Additionally, the tool provides an interactive visualization for summarizing results based on a forest plot for both binary and time-to-event data.  In summary, the GAC suite of tools provide a one stop shop for conducting statistical analysis to identify and visualize the association between a clinical outcome of interest and high-dimensional data types, such as genomic data. Our GAC package has been implemented in R and is available via http://shinygispa.winship.emory.edu/GAC/. The developmental repository is available at https://github.com/manalirupji/GAC.

scholarly journals Methods to Analyse Time-to-Event Data: The Kaplan-Meier Survival Curve

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Graziella D’Arrigo ◽  
Daniela Leonardis ◽  
Samar Abd ElHafeez ◽  
Maria Fusaro ◽  
Giovanni Tripepi ◽  
...  
Keyword(s):  
Survival Data ◽  
Molecular Mechanisms ◽  
Survival Curve ◽  
Interval Censoring ◽  
Right Censoring ◽  
Event Data ◽  
Time To Event ◽  
Time To Event Data ◽  
Kaplan Meier ◽  
Meier Survival Curve

Studies performed in the field of oxidative medicine and cellular longevity frequently focus on the association between biomarkers of cellular and molecular mechanisms of oxidative stress as well as of aging, immune function, and vascular biology with specific time to event data, such as mortality and organ failure. Indeed, time-to-event analysis is one of the most important methodologies used in clinical and epidemiological research to address etiological and prognostic hypotheses. Survival data require adequate methods of analyses. Among these, the Kaplan-Meier analysis is the most used one in both observational and interventional studies. In this paper, we describe the mathematical background of this technique and the concept of censoring (right censoring, interval censoring, and left censoring) and report some examples demonstrating how to construct a Kaplan-Meier survival curve and how to apply this method to provide an answer to specific research questions.

scholarly journals Joint modelling of longitudinal and time-to-event data: an illustration using CD4 count and mortality in a cohort of patients initiated on antiretroviral therapy

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nobuhle N. Mchunu ◽  
Henry G. Mwambi ◽  
Tarylee Reddy ◽  
Nonhlanhla Yende-Zuma ◽  
Kogieleum Naidoo
Keyword(s):  
Cox Model ◽  
Joint Model ◽  
Cd4 Count ◽  
Time Varying ◽  
Event Data ◽  
Time To Event ◽  
Joint Modelling ◽  
Risk Of Death ◽  
Time To Event Data ◽  
Over Time

Abstract Background Modelling of longitudinal biomarkers and time-to-event data are important to monitor disease progression. However, these two variables are traditionally analyzed separately or time-varying Cox models are used. The former strategy fails to recognize the shared random-effects from the two processes while the latter assumes that longitudinal biomarkers are exogenous covariates, resulting in inefficient or biased estimates for the time-to-event model. Therefore, we used joint modelling for longitudinal and time-to-event data to assess the effect of longitudinal CD4 count on mortality. Methods We studied 4014 patients from the Centre for the AIDS Programme of Research in South Africa (CAPRISA) who initiated ART between June 2004 and August 2013. We used proportional hazards regression model to assess the effect of baseline characteristics (excluding CD4 count) on mortality, and linear mixed effect models to evaluate the effect of baseline characteristics on the CD4 count evolution over time. Thereafter, the two analytical approaches were amalgamated to form an advanced joint model for studying the effect of longitudinal CD4 count on mortality. To illustrate the virtues of the joint model, the results from the joint model were compared to those from the time-varying Cox model. Results Using joint modelling, we found that lower CD4 count over time was associated with a 1.3-fold increase in the risk of death, (HR: 1.34, 95% CI: 1.27-1.42). Whereas, results from the time-varying Cox model showed lower CD4 count over time was associated with a 1.2-fold increase in the risk of death, (HR: 1.17, 95% CI: 1.12-1.23). Conclusions Joint modelling enabled the assessment of the effect of longitudinal CD4 count on mortality while correcting for shared random effects between longitudinal and time-to-event models. In the era of universal test and treat, the evaluation of CD4 count is still crucial for guiding the initiation and discontinuation of opportunistic infections prophylaxis and assessment of late presenting patients. CD4 count can also be used when immunological failure is suspected as we have shown that it is associated with mortality.

scholarly journals A novel estimator of survival without assumption of censored survival time

2021 ◽  
Author(s):  
Shee-Ping Chen
Keyword(s):  
Survival Time ◽  
Survival Function ◽  
Event Data ◽  
Time To Event ◽  
Survival Probabilities ◽  
Time To Event Data ◽  
Kaplan Meier

Abstract The Kaplan-Meier estimator is commonly used to analyze time-to-event data, but it may over estimate the survival function when censored events occur. Several methods have been developed to adjust the traditional Kaplan-Meier estimator. Most of these adjusted methods are based on their assumptions for survival time of censored events. We here propose a novel estimator of survival without assumption of censored survival time, and it gives sensible estimates of survival probabilities in various censoring conditions.

scholarly journals GAC: Gene Associations with Clinical, a web based application

F1000Research ◽  
2018 ◽  
Vol 6 ◽  
pp. 1039
Author(s):  
Xinyan Zhang ◽  
Manali Rupji ◽  
Jeanne Kowalski
Keyword(s):  
High Dimensional Data ◽  
Interactive Visualization ◽  
High Dimensional ◽  
Forest Plot ◽  
Event Data ◽  
Time To Event ◽  
Web Based ◽  
Link Type ◽  
Time To Event Data ◽  
Clinical Associations

We present GAC, a shiny R based tool for interactive visualization of clinical associations based on high-dimensional data. The tool provides a web-based suite to perform supervised principal component analysis (SuperPC), an approach that uses both high-dimensional data, such as gene expression, combined with clinical data to infer clinical associations. We extended the approach to address binary outcomes, in addition to continuous and time-to-event data in our package, thereby increasing the use and flexibility of SuperPC.  Additionally, the tool provides an interactive visualization for summarizing results based on a forest plot for both binary and time-to-event data.  In summary, the GAC suite of tools provide a one stop shop for conducting statistical analysis to identify and visualize the association between a clinical outcome of interest and high-dimensional data types, such as genomic data. Our GAC package has been implemented in R and is available via http://shinygispa.winship.emory.edu/GAC/. The developmental repository is available at https://github.com/manalirupji/GAC.

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