scholarly journals Frailty in Survival Analysis of Widowhood Mortality

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Elinor Ytterstad

Heterogeneity between individuals has attracted attention in the literature of survival analysis for several decades. Widowed individuals also differ; some are more frail than others and thereby have a higher risk of dying. The traditional hazard rate in a survival model is a measure of population risk and does not provide direct information on the unobservable individual risk. A frailty model is developed and applied on a large Norwegian data set of 452 788 widowed individuals. The model seemed to fit the data well, for both widowers and widows in all age groups. The random frailty term in the model is significant, meaning that widowed persons may have individual hazard rates.

2006 ◽  
Author(s):  
Θεοδώρα Δημητρακοπούλου

The study of events involving an element of time has a long and important history in statistical research and practice. Survival analysis is a collection of statistical procedures for the analysis of data, where the response of interest is the time until an event occurs. Though such events may refer to any designated experience of interest, they are generally referred to as ‘failures’, whereas the time to their occurrences is referred to as ‘lifetime’ or ‘failure time’. Examples of failure times include the lifetimes of machine components in industrial reliability, the durations of strikes or periods of unemployment in economics, the times taken by subjects to complete specified tasks in psychological experimentation and the survival or remission times of patients in clinical trials.Generally speaking, the estimation, prediction or otimization of survival probabilities or life expectancies has become an issue of considerable interest in many different fields of human life and activity. Therefore, survival analysis has developed into an important tool for researchers in many areas, particularly, those involving biomedical studies and industrial life testing. This dissertation is occupied with continuous lifetime models. In this context, the first chapter, provides a short overview on the basic concepts o f survival analysis. Distribution representations of the time to failure are given when the life lengths are measured by a continuous nonnegative random variable and special emphasis is placed on the hazard function due to its intuitive appeal. In the sequel, several univariate popular lifetime distributions are presented and two specialized models designed to describe more complicated failure patterns (competing risks and frailty models) are briefly examined. The basic concepts of survival analysis for bivariate populations are considered next and the most popular bivariate lifetime distributions are reported. In the second chapter, various statistical properties and reliability aspects of a two parameter distribution with decreasing and increasing failure rates are explored. The model includes the Exponential-Geometric distribution (Adamidis and Loukas, 1988) as a special case. Characterizations are given and the estimation of parameters is studied by the method of maximum likelihood. An EM algorithm (Dempster et al., 1977) is proposed for computing the estimates and expressions for their asymptotic variances and covariances are derived. Numerical examples based on real data are shown, to illustrate the applicability of the new model. The results of this chapter are included in Adamidis et al. (2005).Though the most popular lifetime models are those with monotone hazard rates, when the entire life span of a biological entity or a manufactured item is under consideration, high initial and eventual failure rates are frequently observed, indicating a bathtub shaped failure rate (Gaver and Acar, 1979). Also, situations involving a high occurrence of early ‘failures’ are best modeled by distributions with upturned bathtub shaped hazard rates (Chhikara and Folks, 1977). In the third chapter, a three parameter lifetime distribution with increasing, decreasing, bathtub and upside down bathtub shaped failure rates is introduced. The new model includes the Weibull distribution as a special case. A motivation for its derivation is given using a competing risks interpretation when restricting its parametric space. Several of its statistical properties and reliability aspects are explored and the estimation of the parameters is studied using the standard maximum likelihood procedures. Applications of the model to real data are also included. The results of this chapter are included in Dimitrakopoulou et al. (2006 b). In the forth chapter, bivariate extensions of the model introduced in the second chapter are presented, along with the physical considerations leading to their derivation. Marginal and conditional distributions are obtained and their corresponding survival and hazard functions are calculated. The dependence in the proposed bivariate distributions is evaluated by means of the Pearson correlation coefficient. The models presented so far, implicitly assume that the population under study is homogeneous, an assumption which is often unrealistic in practice. However, heterogeneity is not only of interest in its own right but actually distorts what is observed. One o f the ways of assessing the impact of heterogeneity in mortality studies is via the concept of frailty introduced by Vaupel et al. (1979). When the multiplicative frailty model is underconsideration (e.g. Hougaard, 1984), the assumption of a gamma distributed frailty leads to the so called gamma frailty model. Chapter five, is devoted to exploiting some aspects of its relevant distribution theory. Failure rate characterizations are obtained and bounds on the survival function are constructed. Moreover, it is shown that the model can serve as a method of constructing lifetime models or extending existing ones (by adding a parameter in the sense of Marsall and Olkin, (1997)). Therefore, the investigation of its reliability aspects, provides a unified approach in studying lifetime distributions in a reliability context and a way of assessing the impact of the ‘average’ individual survival capacity - in the presence of heterogeneity - on what is actually observed. The results of this chapter are included in Dimitrakopoulou et al. (2006 a).


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Idika E. Okorie ◽  
Ricardo Moyo ◽  
Saralees Nadarajah

AbstractWe provide a survival analysis of cancer patients in Zimbabwe. Our results show that young cancer patients have lower but not significant hazard rate compared to old cancer patients. Male cancer patients have lower but not significant hazard rate compared to female cancer patients. Race and marital status are significant risk factors for cancer patients in Zimbabwe.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sergio Palacios-Fernandez ◽  
Mario Salcedo ◽  
Gregorio Gonzalez-Alcaide ◽  
Jose-Manuel Ramos-Rincon

Abstract Background The aging population is an increasing concern in Western hospital systems. The aim of this study was to describe the main characteristics and hospitalization patterns in inpatients aged 85 years or more in Spain from 2000 to 2015. Methods Retrospective observational study analyzing data from the minimum basic data set, an administrative registry recording each hospital discharge in Spain since 1997. We collected administrative, economic and clinical data for all discharges between 2000 and 2015 in patients aged 85 years and older, reporting results in three age groups and four time periods to assess differences and compare trends. Results There were 4,387,326 discharges in very elderly patients in Spain from 2000 to 2015, representing 5.32% of total discharges in 2000–2003 and 10.42% in 2012–2015. The pace of growth was faster in older age groups, with an annual percentage increase of 6% in patients aged 85–89 years, 7.79% in those aged 90–94 years, and 8.06% in those aged 95 and older. The proportion of men also rose (37.30 to 39.70%, p < 0.001). The proportion of patients that died during hospital admission decreased from 14.64% in 2000–2003 to 13.83% in 2012–2015 (p < 0.001), and mean length of stay from 9.98 days in 2000–2003 to 8.34 days in 2012–2015. Some of the most frequent primary diagnoses became even more frequent relative to the total number of primary diagnoses, such as heart failure (7.84 to 10.62%), pneumonia (6.36 to 7.36%), other respiratory diseases (3.87 to 8.49%) or other alterations of urinary tract (3.08 to 5.20%). However, there was a relative decrease in the proportion of femoral neck fractures (8.07 to 6.77%), neoplasms (7.65 to 7.34%), ischemic encephalopathy (6.97 to 5.85%), COPD (4.23 to 3.15%), ischemic cardiomyopathy (4.20 to 8.49%) and cholelithiasis (3.07 to 3.28%). Conclusions Discharges in the very elderly population are increasing in both relative and absolute terms in Spanish hospitals. Within this group, discharged patients are getting older and more frequently male. The mean length of stay and the proportion of patients that died during hospital admission are decreasing. Acute-on-chronic organ diseases, neoplasms, acute cardiovascular diseases, and infections are the most common causes of discharge.


2014 ◽  
Vol 962-965 ◽  
pp. 2580-2583
Author(s):  
Ya Chen Zhao ◽  
Zhen Yu Zhang ◽  
Qing Jie Zheng

With the development of the economy, people have higher request for the time. Studying the choice of travel about rail passengers becomes more significant. Due to these problem above and using survival analysis method, this paper builds travel time survival model based on questionnaire and have a whole analysis of the travel time of the rail passenger. Then, it concludes that most of the rail passengers’ travel time is below five hours. At last, this paper builds COX proportional hazard rate model of travel time and study the factors about travel time. The result demonstrates that the factor about whether it is students or not, family income, whether it is travelling and the number of packages has a significant influence on the travel time.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S498-S498
Author(s):  
Ceara Somerville ◽  
Nidya Velasco Roldan ◽  
Cindy N Bui ◽  
Caitlin E Coyle

Abstract Senior centers are an integral community resource, providing programs and services intended to meet the vast range of needs and interests of older adults. There is a growing literature describing senior center participants and benefits to participation, but little is known about those who choose not to participate at a local senior center. This presentation uniquely characterizes non-users of senior centers, based on a sample of community-dwelling adults aged 50+ from seven communities in Massachusetts (N = 9,462). To date, this is the largest data set that describes senior center usage. Most of the sample were women (60%) and in the 60-69 age group (36%). More than three quarters of the sample do not use the local senior center (77%). The most common reasons for non-usage were lack of interest (27%) and not feeling old enough (26%). There are significant differences in reasons of non-usage among age groups and gender (p &lt; .001). Younger age groups’ (50-69) most popular reasons for non-usage were not feeling old enough, not having time, inconvenient senior center hours, and not knowing what is offered. In contrast, older age groups (80+) more frequently reported having no interest or using programs elsewhere. Men were more likely to report not being interested and not being familiar with what is offered. Women were more likely to report not having time, inconvenient hours of programming, and using programs elsewhere. Based on results from this study, this presentation will outline implications for the future of senior centers and their programming.


Author(s):  
Guizhou Hu ◽  
Martin M. Root

Background No methodology is currently available to allow the combining of individual risk factor information derived from different longitudinal studies for a chronic disease in a multivariate fashion. This paper introduces such a methodology, named Synthesis Analysis, which is essentially a multivariate meta-analytic technique. Design The construction and validation of statistical models using available data sets. Methods and results Two analyses are presented. (1) With the same data, Synthesis Analysis produced a similar prediction model to the conventional regression approach when using the same risk variables. Synthesis Analysis produced better prediction models when additional risk variables were added. (2) A four-variable empirical logistic model for death from coronary heart disease was developed with data from the Framingham Heart Study. A synthesized prediction model with five new variables added to this empirical model was developed using Synthesis Analysis and literature information. This model was then compared with the four-variable empirical model using the first National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study data set. The synthesized model had significantly improved predictive power ( x2 = 43.8, P < 0.00001). Conclusions Synthesis Analysis provides a new means of developing complex disease predictive models from the medical literature.


2018 ◽  
Vol 112 (3) ◽  
pp. 109-118 ◽  
Author(s):  
Graham Kirkwood ◽  
Thomas C Hughes ◽  
Allyson M Pollock

Summary Objectives To analyse and report on sports-related injuries using enhanced injury data collected by the testbed for the NHS emergency care injury data set and admissions data collected from inpatients. Design Ecological study design. Setting Two Oxfordshire NHS England hospitals. Participants Emergency department attendees and inpatients aged 0–19 years with sports injuries. Main outcome measures Data were analysed from 1 January 2012 to 30 March 2014 by age, gender sport, injury location, injury mechanism and diagnosis including concussion/post-concussion, bone fractures and ligament damage. Admissions data were analysed from 1 January 2012 to 24 January 2015. Results Children and adolescents aged 0–19 years accounted for almost half (47.4%) of sports injury-related emergency department attendances and almost one-quarter (23.5%) of sports injury-related admissions for all ages. The highest rates of attendance occurred at 14 years for boys (68.22 per 1000 person-years) and 12 years for girls (33.72 per 1000 person-years). For male 0–19-year-olds the three main sports were (in order) football (soccer), rugby union and rugby league and for females, trampoline, netball and horse-riding. The largest gender differences were in netball where injuries were predominantly in females and in wheeled motorsports where injuries were predominantly in males. Almost one-quarter of emergency department sports-related injuries recorded were fractures, the highest percentage to the upper limbs. Conclusions Public health departments in local authorities and schools should consider target sports injury prevention at children in the first four years of secondary school. For younger age groups, trampolines in the home warrant improved safety. Rugby and horse-riding should also be a focus for interventions.


Entropy ◽  
2018 ◽  
Vol 20 (9) ◽  
pp. 642 ◽  
Author(s):  
Erlandson Saraiva ◽  
Adriano Suzuki ◽  
Luis Milan

In this paper, we study the performance of Bayesian computational methods to estimate the parameters of a bivariate survival model based on the Ali–Mikhail–Haq copula with marginal distributions given by Weibull distributions. The estimation procedure was based on Monte Carlo Markov Chain (MCMC) algorithms. We present three version of the Metropolis–Hastings algorithm: Independent Metropolis–Hastings (IMH), Random Walk Metropolis (RWM) and Metropolis–Hastings with a natural-candidate generating density (MH). Since the creation of a good candidate generating density in IMH and RWM may be difficult, we also describe how to update a parameter of interest using the slice sampling (SS) method. A simulation study was carried out to compare the performances of the IMH, RWM and SS. A comparison was made using the sample root mean square error as an indicator of performance. Results obtained from the simulations show that the SS algorithm is an effective alternative to the IMH and RWM methods when simulating values from the posterior distribution, especially for small sample sizes. We also applied these methods to a real data set.


2004 ◽  
Vol 2 (2) ◽  
pp. 20-27
Author(s):  
Kofi Adade Boafo ◽  
Bruce Smith ◽  
Naomi N Modeste ◽  
Thomas J Prendergast, Jr

Objective: The purpose of this cohort, descriptive study was to attempt to understand the variables associated with discordant infant mortality among teenagers 17-19 years old whose infants demonstrated higher mortality than infants of teenagers who were younger than 17 years old in San Bernardino County, California. The intent was to elicit further research and/or define appropriate interventions for teen mothers within the age range 17-19 years. Methods: Data was abstracted from an electronic infant mortality data set, the State of California Birth Cohort File in which birth records from San Bernardino County for the period 1989 through 1993 were matched with mortality records. Results: The data showed that infants of white teens within the 17-19 age groups were more likely to have higher infant mortality rates when compared to their younger peers. Infant mortality rates among offspring of Hispanic and black teenage mothers showed no discrepancy between the two groups nor between county and state rates. Conclusions: Further study is needed to answer why infants of white teen mothers in the 17-19 age groups have higher mortality rates. There is also a need to review the services rendered to pregnant and parenting adolescents in San Bernardino County. In addition, very low birth weight infants were much more likely to die when born to older teens than when born to younger teens.


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