Estimating a patient's mortality risk is important in making treatment decisions. Survival trees are a useful tool and employ recursive partitioning to separate patients into different risk groups. Existing 'loss based' recursive partitioning procedures that would be used in the absence of censoring have previously been extended to the setting of right censored outcomes using inverse probability censoring weighted estimators of loss functions. In this paper, we propose new 'doubly robust' extensions of these loss estimators motivated by semiparametric efficiency theory for missing data that better utilize available data. Simulations and a data analysis demonstrate strong performance of the doubly robust survival trees compared with previously used methods. Copyright © 2016 John Wiley & Sons, Ltd.

This paper proposes a novel paradigm for building regression trees and ensemble learning in survival analysis. Generalizations of the CART and Random Forests algorithms for general loss functions, and in the latter case more general bootstrap procedures, are both introduced. These results, in combination with an extension of the theory of censoring unbiased transformations applicable to loss functions, underpin the development of two new classes of algorithms for constructing survival trees and survival forests: Censoring Unbiased Regression Trees and Censoring Unbiased Regression Ensembles. For a certain “doubly robust” censoring unbiased transformation of squared error loss, we further show how these new algorithms can be implemented using existing software (e.g., CART, random forests). Comparisons of these methods to existing ensemble procedures for predicting survival probabilities are provided in both simulated settings and through applications to four datasets. It is shown that these new methods either improve upon, or remain competitive with, existing implementations of random survival forests, conditional inference forests, and recursively imputed survival trees.

SummaryMany chronic diseases feature recurring clinically important events. In addition, however, there often exists a random variable which is realized upon the occurrence of each event reflecting the severity of the event, a cost associated with it, or possibly a short term response indicating the effect of a therapeutic intervention. We describe a novel model for a marked point process which incorporates a dependence between continuous marks and the event process through the use of a copula function. The copula formulation ensures that event times can be modeled by any intensity function for point processes, and any multivariate model can be specified for the continuous marks. The relative efficiency of joint versus separate analyses of the event times and the marks is examined through simulation under random censoring. An application to data from a recent trial in transfusion medicine is given for illustration.

Large cohort studies now routinely involve biobanks in which biospecimens are stored for use in future biomarker studies. In such settings, two-phase response-dependent sampling designs involve subsampling individuals in the cohort, assaying their biospecimen to measure an expensive biomarker, and using this data to estimate key parameters of interest under budgetary constraints. When analyses are based on inverse probability weighted estimating functions, recent work has described adaptive two-phase designs in which a preliminary phase of subsampling based on a standard design facilitates approximation of an optimal selection model for a second subsampling phase. In this article, we refine the definition of an optimal subsampling scheme within the framework of adaptive two-phase designs, describe how adaptive two-phase designs can be used when analyses are based on likelihood or conditional likelihood, and consider the setting of a continuous biomarker where the nuisance covariate distribution is estimated nonparametrically at the design stage and analysis stage as required; efficiency and robustness issues are investigated. We also explore these methods for the surrogate variable problem and describe a generalization to accommodate multiple stages of phase II subsampling. A study involving individuals with psoriatic arthritis is considered for illustration, where the aim is to assess the association between the biomarker MMP-3 and the development of joint damage.

A copula-based model is described which enables joint analysis of multiple progressive multistate processes. Unlike intensity-based or frailty-based approaches to joint modeling, the copula formulation proposed herein ensures that a wide range of marginal multistate processes can be specified and the joint model will retain these marginal features. The copula formulation also facilitates a variety of approaches to estimation and inference including composite likelihood and two-stage estimation procedures. We consider processes with Markov margins in detail, which are often suitable when chronic diseases are progressive in nature. We give special attention to the setting in which individuals are examined intermittently and transition times are consequently interval-censored. Simulation studies give empirical insight into the different methods of analysis and an application involving progression in joint damage in psoriatic arthritis provides further illustration.