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Related Experiment Videos

Correcting for selection using frailty models.

Anne Vingaard Olesen1, Erik Thorlund Parner

  • 1Department of Epidemiology, Institute of Public Health, University of Aarhus, Denmark. avo@soci.au.dk

Statistics in Medicine
|October 28, 2005
PubMed
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Chronic diseases involve cycles of relapse and recovery. This study on schizophrenia readmissions surprisingly found a stable disease course, challenging existing literature.

Area of Science:

  • Biostatistics
  • Epidemiology
  • Psychiatry

Background:

  • Chronic diseases are characterized by recurrent relapse and recovery states.
  • Analyzing long-term relapse patterns requires robust statistical models for longitudinal data.
  • Previous analyses of recurrent events face challenges like selection bias and dependent censoring.

Purpose of the Study:

  • To theoretically verify the shared frailty model for analyzing recurrent event data with potential informative gaps.
  • To investigate the impact of informative gaps and staggered entry on inference in shared frailty models.
  • To analyze routine register data on schizophrenia readmissions to estimate survival curves and assess disease course stability.

Main Methods:

  • Theoretical verification of conditional independence assumption in shared frailty models.

Related Experiment Videos

  • Simulation studies to assess the impact of informative gaps and staggered entry.
  • Analysis of routine register data on hospital readmissions for nearly 9000 schizophrenia patients using the shared frailty model.

    • Main Results:

    • The shared frailty model can be extended to situations with frailty-dependent gaps, provided gaps are short relative to event times.
    • Consistent inference is achievable under the assumption of conditional independence of risk times and gaps given latent frailty.
    • Analysis of schizophrenia readmission data revealed surprisingly stable disease trajectories, contrary to expectations from existing literature.

    Conclusions:

    • The shared frailty model offers a flexible framework for analyzing recurrent events, even with informative censoring.
    • The study's findings suggest a potentially more stable course for schizophrenia than commonly assumed.
    • Further research is warranted to explore the implications of these findings for clinical practice and disease management.