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Comparison of Penalized Cox Regression Methods in Low-Dimensional Data with Few-Events: An Application to Dialysis Patients' Data

Background: Dialysis is a dominant therapeutic method in patients with chronic renal failure. The ratio of those who experienced the event to the predictor variables is expressed as event per variable (EPV). When EPV is low, one of the common techniques which may help to manage the problem is penali...

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Autores principales: Rafati, Shideh, Baneshi, Mohammad Reza, Hassani, Laleh, Bahrampour, Abbas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hamadan University of Medical Sciences 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183557/
https://www.ncbi.nlm.nih.gov/pubmed/31586373
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author Rafati, Shideh
Baneshi, Mohammad Reza
Hassani, Laleh
Bahrampour, Abbas
author_facet Rafati, Shideh
Baneshi, Mohammad Reza
Hassani, Laleh
Bahrampour, Abbas
author_sort Rafati, Shideh
collection PubMed
description Background: Dialysis is a dominant therapeutic method in patients with chronic renal failure. The ratio of those who experienced the event to the predictor variables is expressed as event per variable (EPV). When EPV is low, one of the common techniques which may help to manage the problem is penalized Cox regression model (PCRM). The aim of this study was to determine the survival of dialysis patients using the PCRM in low-dimensional data with few events. Study design: A cross-sectional study. Methods: Information of 252 dialysis patients of Bandar Abbas hospitals, southern Iran, from 2010-16 were used. To deal with few mortality cases in the sample, the PCRM (lasso, ridge and elastic net, adaptive lasso) were applied. Models were compared in terms of calibration and discrimination. Results: Thirty-five (13.9%) mortality cases were observed. Dialysis data simulations revealed that the lasso had higher prediction accuracy than other models. For one unit of increase in the level of education, the risk of mortality was reduced by 0.32 (HR=0.68). The risk of mortality was 0.26 (HR=1.26) higher for the unemployed than the employed cases. Other significant factors were the duration of each dialysis session, number of dialysis sessions per week and age of dialysis onset (HR=0.93, 0.95 and 1.33). Conclusion: The performance of penalized models, especially the lasso, was satisfying in low-dimensional data with low EPV based on dialysis data simulation and real data, therefore these models are the good choice for managing of this type of data.
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spelling pubmed-71835572020-05-11 Comparison of Penalized Cox Regression Methods in Low-Dimensional Data with Few-Events: An Application to Dialysis Patients' Data Rafati, Shideh Baneshi, Mohammad Reza Hassani, Laleh Bahrampour, Abbas J Res Health Sci Original Article Background: Dialysis is a dominant therapeutic method in patients with chronic renal failure. The ratio of those who experienced the event to the predictor variables is expressed as event per variable (EPV). When EPV is low, one of the common techniques which may help to manage the problem is penalized Cox regression model (PCRM). The aim of this study was to determine the survival of dialysis patients using the PCRM in low-dimensional data with few events. Study design: A cross-sectional study. Methods: Information of 252 dialysis patients of Bandar Abbas hospitals, southern Iran, from 2010-16 were used. To deal with few mortality cases in the sample, the PCRM (lasso, ridge and elastic net, adaptive lasso) were applied. Models were compared in terms of calibration and discrimination. Results: Thirty-five (13.9%) mortality cases were observed. Dialysis data simulations revealed that the lasso had higher prediction accuracy than other models. For one unit of increase in the level of education, the risk of mortality was reduced by 0.32 (HR=0.68). The risk of mortality was 0.26 (HR=1.26) higher for the unemployed than the employed cases. Other significant factors were the duration of each dialysis session, number of dialysis sessions per week and age of dialysis onset (HR=0.93, 0.95 and 1.33). Conclusion: The performance of penalized models, especially the lasso, was satisfying in low-dimensional data with low EPV based on dialysis data simulation and real data, therefore these models are the good choice for managing of this type of data. Hamadan University of Medical Sciences 2019-07-15 /pmc/articles/PMC7183557/ /pubmed/31586373 Text en © 2019 The Author(s); Published by Hamadan University of Medical Sciences. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Rafati, Shideh
Baneshi, Mohammad Reza
Hassani, Laleh
Bahrampour, Abbas
Comparison of Penalized Cox Regression Methods in Low-Dimensional Data with Few-Events: An Application to Dialysis Patients' Data
title Comparison of Penalized Cox Regression Methods in Low-Dimensional Data with Few-Events: An Application to Dialysis Patients' Data
title_full Comparison of Penalized Cox Regression Methods in Low-Dimensional Data with Few-Events: An Application to Dialysis Patients' Data
title_fullStr Comparison of Penalized Cox Regression Methods in Low-Dimensional Data with Few-Events: An Application to Dialysis Patients' Data
title_full_unstemmed Comparison of Penalized Cox Regression Methods in Low-Dimensional Data with Few-Events: An Application to Dialysis Patients' Data
title_short Comparison of Penalized Cox Regression Methods in Low-Dimensional Data with Few-Events: An Application to Dialysis Patients' Data
title_sort comparison of penalized cox regression methods in low-dimensional data with few-events: an application to dialysis patients' data
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183557/
https://www.ncbi.nlm.nih.gov/pubmed/31586373
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