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Imputation methods for missing failure times in recurrent-event survival analysis: Application to suicide attempts in the transgender population

Suicide risk among transgender populations is an important public health issue. In a project evaluating association between gender affirmation and suicide attempts in the US Transgender Survey, we evaluated the relationship between gender affirmation and risk for suicide attempts. One of the challen...

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Detalles Bibliográficos
Autores principales: Liu, Shanshan, Reisner, Sari L., Herman, Jody L., Weller, Edie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9733870/
https://www.ncbi.nlm.nih.gov/pubmed/36490295
http://dx.doi.org/10.1371/journal.pone.0278913
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author Liu, Shanshan
Reisner, Sari L.
Herman, Jody L.
Weller, Edie
author_facet Liu, Shanshan
Reisner, Sari L.
Herman, Jody L.
Weller, Edie
author_sort Liu, Shanshan
collection PubMed
description Suicide risk among transgender populations is an important public health issue. In a project evaluating association between gender affirmation and suicide attempts in the US Transgender Survey, we evaluated the relationship between gender affirmation and risk for suicide attempts. One of the challenges is that the age at suicide attempts was only collected for the first and last attempt. The initial zero-inflated negative binomial model enabled us to evaluate the association between gender affirmation and number of suicide attempts per 5 years adjusting for other covariates. However, ignoring missing failure times of recurrent events may have caused bias and loss of efficiency. In this paper, we use a recurrent-event survival analysis incorporating time-varying covariates with three approaches to impute the age at suicide attempt, estimates from three imputation approaches are similar. We were able to confirm the findings from the initial model and identify additional associations that were not detected in the initial analysis. Findings suggest the need to consider additional analytical approaches in settings with high data missingness by design. Research to validate and compare measures that ask first and last attempt to those which enumerate all attempts in this population will be important for future surveys.
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spelling pubmed-97338702022-12-10 Imputation methods for missing failure times in recurrent-event survival analysis: Application to suicide attempts in the transgender population Liu, Shanshan Reisner, Sari L. Herman, Jody L. Weller, Edie PLoS One Research Article Suicide risk among transgender populations is an important public health issue. In a project evaluating association between gender affirmation and suicide attempts in the US Transgender Survey, we evaluated the relationship between gender affirmation and risk for suicide attempts. One of the challenges is that the age at suicide attempts was only collected for the first and last attempt. The initial zero-inflated negative binomial model enabled us to evaluate the association between gender affirmation and number of suicide attempts per 5 years adjusting for other covariates. However, ignoring missing failure times of recurrent events may have caused bias and loss of efficiency. In this paper, we use a recurrent-event survival analysis incorporating time-varying covariates with three approaches to impute the age at suicide attempt, estimates from three imputation approaches are similar. We were able to confirm the findings from the initial model and identify additional associations that were not detected in the initial analysis. Findings suggest the need to consider additional analytical approaches in settings with high data missingness by design. Research to validate and compare measures that ask first and last attempt to those which enumerate all attempts in this population will be important for future surveys. Public Library of Science 2022-12-09 /pmc/articles/PMC9733870/ /pubmed/36490295 http://dx.doi.org/10.1371/journal.pone.0278913 Text en © 2022 Liu et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Liu, Shanshan
Reisner, Sari L.
Herman, Jody L.
Weller, Edie
Imputation methods for missing failure times in recurrent-event survival analysis: Application to suicide attempts in the transgender population
title Imputation methods for missing failure times in recurrent-event survival analysis: Application to suicide attempts in the transgender population
title_full Imputation methods for missing failure times in recurrent-event survival analysis: Application to suicide attempts in the transgender population
title_fullStr Imputation methods for missing failure times in recurrent-event survival analysis: Application to suicide attempts in the transgender population
title_full_unstemmed Imputation methods for missing failure times in recurrent-event survival analysis: Application to suicide attempts in the transgender population
title_short Imputation methods for missing failure times in recurrent-event survival analysis: Application to suicide attempts in the transgender population
title_sort imputation methods for missing failure times in recurrent-event survival analysis: application to suicide attempts in the transgender population
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9733870/
https://www.ncbi.nlm.nih.gov/pubmed/36490295
http://dx.doi.org/10.1371/journal.pone.0278913
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