Additive hazard regression models: An application to the natural history of human papillomavirus

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Abstract

There are several statistical methods for time-to-event analysis, among which is the Cox proportional hazards model that is most commonly used. However, when the absolute change in risk, instead of the risk ratio, is of primary interest or when the proportional hazard assumption for the Cox proportional hazards model is violated, an additive hazard regression model may be more appropriate. In this paper, we give an overview of this approach and then apply a semiparametric as well as a nonparametric additive model to a data set from a study of the natural history of human papillomavirus (HPV) in HIV-positive and HIV-negative women. The results from the semiparametric model indicated on average an additional 14 oncogenic HPV infections per 100 woman-years related to CD4 count < 200 relative to HIV-negative women, and those from the nonparametric additive model showed an additional 40 oncogenic HPV infections per 100 women over 5 years of followup, while the estimated hazard ratio in the Cox model was 3.82. Although the Cox model can provide a better understanding of the exposure disease association, the additive model is often more useful for public health planning and intervention.

Original languageEnglish (US)
Article number796270
JournalComputational and Mathematical Methods in Medicine
Volume2013
DOIs
StatePublished - 2013

Fingerprint

Hazard Models
Additive Models
Natural History
Proportional Hazards Models
Regression Model
Hazards
Cox Proportional Hazards Model
Cox Model
Nonparametric Model
Infection
Papillomavirus Infections
HIV
Proportional Hazards
Semiparametric Model
Public Health
Hazard
Statistical method
Count
Health Planning
Planning

ASJC Scopus subject areas

  • Applied Mathematics
  • Modeling and Simulation
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)
  • Immunology and Microbiology(all)

Cite this

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title = "Additive hazard regression models: An application to the natural history of human papillomavirus",
abstract = "There are several statistical methods for time-to-event analysis, among which is the Cox proportional hazards model that is most commonly used. However, when the absolute change in risk, instead of the risk ratio, is of primary interest or when the proportional hazard assumption for the Cox proportional hazards model is violated, an additive hazard regression model may be more appropriate. In this paper, we give an overview of this approach and then apply a semiparametric as well as a nonparametric additive model to a data set from a study of the natural history of human papillomavirus (HPV) in HIV-positive and HIV-negative women. The results from the semiparametric model indicated on average an additional 14 oncogenic HPV infections per 100 woman-years related to CD4 count < 200 relative to HIV-negative women, and those from the nonparametric additive model showed an additional 40 oncogenic HPV infections per 100 women over 5 years of followup, while the estimated hazard ratio in the Cox model was 3.82. Although the Cox model can provide a better understanding of the exposure disease association, the additive model is often more useful for public health planning and intervention.",
author = "Xianhong Xie and Howard Strickler and Xue, {Xiaonan (Nan)}",
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