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

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    Author(s)
    Rafati, Shideh
    Baneshi, Mohammad Reza
    Hassani, Laleh
    Bahrampour, Abbas
    Griffith University Author(s)
    Bahrampour, Abbas
    Year published
    2019
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    Abstract
    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 ...
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    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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    Journal Title
    Journal of Research in Health Sciences
    Volume
    19
    Issue
    3
    Copyright Statement
    © 2019 The Author(s); Published by Hamadan University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Subject
    Public health
    Nephrology and urology
    Science & Technology
    Life Sciences & Biomedicine
    Public, Environmental & Occupational Health
    Chronic renal failure
    Dialysis
    Publication URI
    http://hdl.handle.net/10072/396336
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    • Journal articles

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