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A Comparative Study of Different Joint Modeling Approaches for HIV/AIDS Patients in Southern Iran

BACKGROUND: The prevalence of HIV/AIDS has been increasing in Iran, especially amongst the young population, recently. The joint model (JM) is a statistical method that represents an effective strategy to incorporate all information of repeated measurements and survival outcomes simultaneously. In m...

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Autores principales: ROUSTAEI, Narges, JAMALI, Jamshid, TAGHI AYATOLLAHI, Seyyed Mohammad, ZARE, Najaf
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Tehran University of Medical Sciences 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7898094/
https://www.ncbi.nlm.nih.gov/pubmed/33643954
http://dx.doi.org/10.18502/ijph.v49i9.4099
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author ROUSTAEI, Narges
JAMALI, Jamshid
TAGHI AYATOLLAHI, Seyyed Mohammad
ZARE, Najaf
author_facet ROUSTAEI, Narges
JAMALI, Jamshid
TAGHI AYATOLLAHI, Seyyed Mohammad
ZARE, Najaf
author_sort ROUSTAEI, Narges
collection PubMed
description BACKGROUND: The prevalence of HIV/AIDS has been increasing in Iran, especially amongst the young population, recently. The joint model (JM) is a statistical method that represents an effective strategy to incorporate all information of repeated measurements and survival outcomes simultaneously. In many theoretical studies, the population under the study were heterogeneous. This study aimed at comparing three approaches by considering heterogeneity in the patients. METHODS: This study was conducted on 750 archived files of patients infected with HIV in Fars Province, southern Iran, from 1994 to 2017. Proposed Approach (PA), Joint Latent Class Models (JLCM), and Separated Approach (SA) were compared to evaluate the influence covariates on the longitudinal and time-to-event outcomes in the heterogeneous HIV/AIDS patients. RESULTS: Gender (P<0.001) and HCV (P<0.01) were two significant covariates in the classification of HIV/AIDS patients. Time had a significant effect on CD4 (P<0.001) in both classes in the three approaches. In PA and SA, females had higher CD4 than males (P<0.001) in the first class. In JLCM, females had higher CD4 than males (P<0.01) in both classes. The patients with higher Hgb had also higher CD4 (P<0.001) in both classes in the three approaches. HCV reduced the CD4 significantly in both classes in PA (P<0.05) and SA (P<0.001). Within the survival sub-model, HCV reduced survival rate significantly in the second class in PA (P<0.05), JLCM (P<0.01) and SA (P<0.001). CONCLUSION: PA was an appropriate approach for joint modeling longitudinal and survival outcomes for this heterogeneous population.
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spelling pubmed-78980942021-02-25 A Comparative Study of Different Joint Modeling Approaches for HIV/AIDS Patients in Southern Iran ROUSTAEI, Narges JAMALI, Jamshid TAGHI AYATOLLAHI, Seyyed Mohammad ZARE, Najaf Iran J Public Health Original Article BACKGROUND: The prevalence of HIV/AIDS has been increasing in Iran, especially amongst the young population, recently. The joint model (JM) is a statistical method that represents an effective strategy to incorporate all information of repeated measurements and survival outcomes simultaneously. In many theoretical studies, the population under the study were heterogeneous. This study aimed at comparing three approaches by considering heterogeneity in the patients. METHODS: This study was conducted on 750 archived files of patients infected with HIV in Fars Province, southern Iran, from 1994 to 2017. Proposed Approach (PA), Joint Latent Class Models (JLCM), and Separated Approach (SA) were compared to evaluate the influence covariates on the longitudinal and time-to-event outcomes in the heterogeneous HIV/AIDS patients. RESULTS: Gender (P<0.001) and HCV (P<0.01) were two significant covariates in the classification of HIV/AIDS patients. Time had a significant effect on CD4 (P<0.001) in both classes in the three approaches. In PA and SA, females had higher CD4 than males (P<0.001) in the first class. In JLCM, females had higher CD4 than males (P<0.01) in both classes. The patients with higher Hgb had also higher CD4 (P<0.001) in both classes in the three approaches. HCV reduced the CD4 significantly in both classes in PA (P<0.05) and SA (P<0.001). Within the survival sub-model, HCV reduced survival rate significantly in the second class in PA (P<0.05), JLCM (P<0.01) and SA (P<0.001). CONCLUSION: PA was an appropriate approach for joint modeling longitudinal and survival outcomes for this heterogeneous population. Tehran University of Medical Sciences 2020-09 /pmc/articles/PMC7898094/ /pubmed/33643954 http://dx.doi.org/10.18502/ijph.v49i9.4099 Text en Copyright © 2020 Roustaei et al. Published by Tehran University of Medical Sciences https://creativecommons.org/licenses/by-nc/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license (https://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of the work are permitted, provided the original work is properly cited.
spellingShingle Original Article
ROUSTAEI, Narges
JAMALI, Jamshid
TAGHI AYATOLLAHI, Seyyed Mohammad
ZARE, Najaf
A Comparative Study of Different Joint Modeling Approaches for HIV/AIDS Patients in Southern Iran
title A Comparative Study of Different Joint Modeling Approaches for HIV/AIDS Patients in Southern Iran
title_full A Comparative Study of Different Joint Modeling Approaches for HIV/AIDS Patients in Southern Iran
title_fullStr A Comparative Study of Different Joint Modeling Approaches for HIV/AIDS Patients in Southern Iran
title_full_unstemmed A Comparative Study of Different Joint Modeling Approaches for HIV/AIDS Patients in Southern Iran
title_short A Comparative Study of Different Joint Modeling Approaches for HIV/AIDS Patients in Southern Iran
title_sort comparative study of different joint modeling approaches for hiv/aids patients in southern iran
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7898094/
https://www.ncbi.nlm.nih.gov/pubmed/33643954
http://dx.doi.org/10.18502/ijph.v49i9.4099
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