Recurrent Events Analysis With Data Collected at Informative Clinical Visits in Electronic Health Records

2021
Although increasingly used as a data resource for assembling cohorts, electronic health records (EHRs) pose many analytic challenges. In particular, a patient's health status influences when and what data are recorded, generating sampling bias in the collected data. In this article, we consider recurrent event analysis using EHR data. Conventional regression methods for event risk analysis usually require the values of covariates to be observed throughout the follow-up period. In EHR databases, time-dependent covariates are intermittently measured during clinical visits, and the timing of these visits is informative in the sense that it depends on the disease course. Simple methods, such as the last-observation-carried-forward approach, can lead to biased estimation. On the other hand, complex joint models require additional assumptions on the covariate process and cannot be easily extended to handle multiple longitudinal predictors. By incorporating sampling weights derived from estimating the observation time process, we develop a novel estimation procedure based on inverse-rate-weighting and kernel-smoothing for the semiparametric proportional rate model of recurrent events. The proposed methods do not require model specifications for the covariate processes and can easily handle multiple time-dependent covariates. Our methods are applied to a kidney transplant study for illustration.for this article are available online.
JOURNAL OF THE AMERICAN STATISTICAL ASSOCIATION
页码:594-604|卷号:116|期号:534
ISSN:0162-1459
收录类型
SSCI
发表日期
2021
学科领域
循证社会科学-方法
国家
美国
语种
英语
DOI
10.1080/01621459.2020.1801447
其他关键词
LONGITUDINAL DATA; SEMIPARAMETRIC REGRESSION; OBSERVATION TIMES; CYTOMEGALOVIRUS; MODEL; AREA
EISSN
1537-274X
资助机构
NIHUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [K24AI085118, R01CA193888]; Columbia University Mailman School of Public Health
资助信息
This research was partially supported by NIH R01CA193888. The transplant study was supported in part by NIH K24AI085118. The first author's researchwas partially supportedby theCalderone Junior Faculty Prize from Columbia University Mailman School of Public Health.
被引频次(WOS)
0
被引更新日期
2022-01
来源机构
Columbia University University of California System University of California San Francisco Johns Hopkins University
关键词
Electronic health records Informative observation Kernel smoothing Proportional rate model Recurrent event analysis