Volume 11, Issue 1 (4-2015)
HSR 2015, 11(1): 201-216 |
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Yazdani A, Mansourian M, Amini M. Joint frailty models for over time modeling recurrent events and a final event using penalized likelihood estimation method and its application in medical data. HSR 2015; 11 (1) :201-216
URL: http://hsr.mui.ac.ir/article-1-748-en.html
URL: http://hsr.mui.ac.ir/article-1-748-en.html
1- MSc Student, Department of Biostatistics and Epidemiology, Health School, Isfahan University of Medical Sciences, Isfahan, Iran
2- Assistant, Department of Biostatistics and Epidemiology, Health School, Isfahan University of Medical Sciences, Isfahan, Iran
3- Professor, Isfahan Endocrinology and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2- Assistant, Department of Biostatistics and Epidemiology, Health School, Isfahan University of Medical Sciences, Isfahan, Iran
3- Professor, Isfahan Endocrinology and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract: (809 Views)
Background: Repeated events in cohort studies can be terminated by loss to follow-up, end of the study, or/and a major failure event such as death. In this regard, the major failure event can be correlated with recurrent events. Thus the usual assumption (no-informative censoring of the recurrent event process by death), which considered in many survival approaches, can be violated. Joint modeling, as an appropriate way of analysis for this kind of data, can leads to unbiased and more efficient parameter estimations.Methods: In the present study, joint frailty model with maximum penalized likelihood method was introduced and used for analyzing a cohort study that included first-degree relatives (FDR) of type 2 diabetes patients who attending to Isfahan endocrine and metabolism research center. The R-software (version 2.15.2) was used to fit the models.Findings: The hazard ratios adjusted by energy intake showed that pre-diabetes recurrent rate is 3.48 times higher in individuals who consumed carbohydrate greater than 65 percent energy intake, than that of Individuals with lower than 40 percent energy intake. The hazards for terminal events (diabetes) adjusted by energy intake indicated that the rate of diabetes was 0.19 times higher in individuals who consumed protein 12-15 percent energy intake than that of individuals with protein consumption lower than 12 percent energy intake.Conclusion: Adjusting life style considering nutritional status and anthropometric measure, can affect the prevalence of diabetes between FDRs who have genetics risk factors.Key Words: Diabetes, Joint frailty models, Penalized likelihood, Pre-diabetes, Recurrent events
Type of Study: Research |
Subject:
education health and promotion
Received: 2020/07/16 | Accepted: 2015/04/15 | Published: 2015/04/15
Received: 2020/07/16 | Accepted: 2015/04/15 | Published: 2015/04/15
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