Change point estimation in monitoring survival time.

Precise identification of the time when a change in a hospital outcome has occurred enables clinical experts to search for a potential special cause more effectively. In this paper, we develop change point estimation methods for survival time of a clinical procedure in the presence of patient mix in...

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Main Authors: Hassan Assareh, Kerrie Mengersen
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22438969/pdf/?tool=EBI
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author Hassan Assareh
Kerrie Mengersen
author_facet Hassan Assareh
Kerrie Mengersen
author_sort Hassan Assareh
collection DOAJ
description Precise identification of the time when a change in a hospital outcome has occurred enables clinical experts to search for a potential special cause more effectively. In this paper, we develop change point estimation methods for survival time of a clinical procedure in the presence of patient mix in a Bayesian framework. We apply Bayesian hierarchical models to formulate the change point where there exists a step change in the mean survival time of patients who underwent cardiac surgery. The data are right censored since the monitoring is conducted over a limited follow-up period. We capture the effect of risk factors prior to the surgery using a Weibull accelerated failure time regression model. Markov Chain Monte Carlo is used to obtain posterior distributions of the change point parameters including location and magnitude of changes and also corresponding probabilistic intervals and inferences. The performance of the Bayesian estimator is investigated through simulations and the result shows that precise estimates can be obtained when they are used in conjunction with the risk-adjusted survival time CUSUM control charts for different magnitude scenarios. The proposed estimator shows a better performance where a longer follow-up period, censoring time, is applied. In comparison with the alternative built-in CUSUM estimator, more accurate and precise estimates are obtained by the Bayesian estimator. These superiorities are enhanced when probability quantification, flexibility and generalizability of the Bayesian change point detection model are also considered.
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spelling doaj.art-a4d64ccdb7794daca36fb2cca6ef4c292022-12-21T19:27:11ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0173e3363010.1371/journal.pone.0033630Change point estimation in monitoring survival time.Hassan AssarehKerrie MengersenPrecise identification of the time when a change in a hospital outcome has occurred enables clinical experts to search for a potential special cause more effectively. In this paper, we develop change point estimation methods for survival time of a clinical procedure in the presence of patient mix in a Bayesian framework. We apply Bayesian hierarchical models to formulate the change point where there exists a step change in the mean survival time of patients who underwent cardiac surgery. The data are right censored since the monitoring is conducted over a limited follow-up period. We capture the effect of risk factors prior to the surgery using a Weibull accelerated failure time regression model. Markov Chain Monte Carlo is used to obtain posterior distributions of the change point parameters including location and magnitude of changes and also corresponding probabilistic intervals and inferences. The performance of the Bayesian estimator is investigated through simulations and the result shows that precise estimates can be obtained when they are used in conjunction with the risk-adjusted survival time CUSUM control charts for different magnitude scenarios. The proposed estimator shows a better performance where a longer follow-up period, censoring time, is applied. In comparison with the alternative built-in CUSUM estimator, more accurate and precise estimates are obtained by the Bayesian estimator. These superiorities are enhanced when probability quantification, flexibility and generalizability of the Bayesian change point detection model are also considered.https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22438969/pdf/?tool=EBI
spellingShingle Hassan Assareh
Kerrie Mengersen
Change point estimation in monitoring survival time.
PLoS ONE
title Change point estimation in monitoring survival time.
title_full Change point estimation in monitoring survival time.
title_fullStr Change point estimation in monitoring survival time.
title_full_unstemmed Change point estimation in monitoring survival time.
title_short Change point estimation in monitoring survival time.
title_sort change point estimation in monitoring survival time
url https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22438969/pdf/?tool=EBI
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