Risk-adjusted monitoring of time to event in the presence of long-term survivors
The use of control charts for monitoring schemes in medical context should consider adjustments to incorporate the specific risk for each individual. Some authors propose the use of a risk-adjusted survival time cumulative sum (RASTCUSUM) control chart to monitor a time-to-event outcome, possibly...
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| Principais autores: | , , , |
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| Formato: | article |
| Idioma: | pt_BR |
| Publicado em: |
Wiley Online
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| Assuntos: | |
| Endereço do item: | https://repositorio.ufrn.br/jspui/handle/123456789/30195 |
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| Resumo: | The use of control charts for monitoring schemes in medical context should consider adjustments to
incorporate the specific risk for each individual. Some authors propose the use of a risk-adjusted survival
time cumulative sum (RASTCUSUM) control chart to monitor a time-to-event outcome, possibly right
censored, using conventional survival models, which do not contemplate the possibility of cure of a
patient. We propose to extend this approach considering a risk-adjusted CUSUM chart, based on a
cure rate model. We consider a regression model in which the covariates affect the cure fraction. The
CUSUM scores are obtained for Weibull and log-logistic promotion time model to monitor a scale
parameter for nonimmune individuals. A simulation study was conducted to evaluate and compare
the performance of the proposed chart (RACUF CUSUM) with RAST CUSUM, based on optimal
control limits and average run length in different situations.As a result,we note that the RASTCUSUM
chart is inappropriate when applied to data with a cure rate, while the proposed RACUF CUSUM
chart seems to have similar performance if applied to data without a cure rate. The proposed chart is
illustrated with simulated data and with a real data set of patients with heart failure treated at the Heart
Institute (InCor), at the University of S˜ao Paulo, Brazil. |
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