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Re: Parametric survival models with time dependent covariates

To: Robert Dodier <robert_dodier@yahoo.com>
Subject: Re: Parametric survival models with time dependent covariates
From: Frank E Harrell Jr <fharrell@virginia.edu>
Date: Fri, 31 Jan 2003 15:08:06 -0500
Cc: s-news@lists.biostat.wustl.edu
In-reply-to: <20030131192650.87268.qmail@web41315.mail.yahoo.com>
Organization: University of Virginia
References: <20030131192650.87268.qmail@web41315.mail.yahoo.com>
On Fri, 31 Jan 2003 11:26:50 -0800 (PST)
Robert Dodier <robert_dodier@yahoo.com> wrote:

> Hello,
> 
> I am looking for information about parametric 
> survival models with time dependent covariates.
> The only reference I can find specifically devoted
> to parametric survival (as opposed to Cox models)
> seems to imply that it is not easy to incorporate
> time dependent covariates into a parametric 
> survival model. (See this message dated April 17,
> 2001, in the s-news archive:
> http://www.biostat.wustl.edu/mailinglists/s-news/200104/msg00154.html)
> 
> So, I wonder where the difficulty lies. If I can 
> better understand the problem, perhaps I will be able
> to formulate a workable approximation or some such.
> What is it about time dependent covariates that makes
> the extension of the Cox model straightforward, yet
> parametric survival models more difficult? Is there
> a "brute force" approach which will give the correct
> answer at the price of burdensome computations?
> 
> References to the literature will be very helpful.
> Thank you for your consideration. I appreciate your
> help.
> 
> Regards,
> Robert Dodier
> 

Robert,

I have found that flexible proportional hazards parametric models such as 
spline hazard models do make incorporation and especially understanding of 
time-dependent covariates easier.  The payoff is especially large when you want 
to get confidence bands on survival curves with time-dep cov.  You might look at

@ARTICLE{her95res,
  author = {Herndon, James E. and Harrell, Frank E.},
  year = 1995,
  title = {The restricted cubic spline as baseline hazard in the proportional
          hazards model with step function time-dependent covariables},
  journal = Statistics in Medicine,
  volume = 14,
  pages = {2119-2129},
  annote = {spline; restricted cubic spline; time-dependent covariables; PH
           model}
}

as well as the hare package in S.  I wish we had S functions for the PH spline 
model with time-dep covariates.  We had a SAS procedure for this which SAS 
Institute rendered obsolete with a fundamental change in SAS.
-- 
Frank E Harrell Jr              Prof. of Biostatistics & Statistics
Div. of Biostatistics & Epidem. Dept. of Health Evaluation Sciences
U. Virginia School of Medicine  http://hesweb1.med.virginia.edu/biostat

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