Designing and analyzing studies of onset, cessation, and relapse: using survival analysis in drug abuse prevention research.
Many questions arising in drug abuse prevention and intervention studies focus on whether and, if so, when events occur. When do adolescents start using drugs? Does participation in a drug prevention program at school decrease the risk that high school students will initiate drug use? Does failure to participate in a relapse prevention program at a community health center increase the risk that newly abstinent ex-abusers will start using drugs again? Research questions about event occurrence present unique design and analytic difficulties. The fundamental problem is how to handle censored observations, observations of those people who do not experience the target event during data collection. The methods of survival analysis overcome these difficulties and allow prevention researchers to describe patterns of occurrence, compare these patterns among groups, and build statistical models of the risk of occurrence over time. In this chapter, the authors present a nonmathematical introduction to survival analysis for drug abuse prevention researchers. After developing the basic concepts, they focus on two topics-study design and data analysis-and identify for each the key issues researchers face and provide guidelines for making informed decisions about them. In the process, the authors review how prevention researchers have used the methods to date and point towards new directions for the application of these methods.
Singer
J D
JD
Graduate School of Education, National Center for Educational Statistics, Harvard University, Cambridge, MA 02138, USA.
Willett
J B
JB
D003625:Data Collection; D006801:Humans; D016016:Proportional Hazards Models; D012008:Recurrence; D012107:Research Design; D019966:Substance-Related Disorders / Q000517:prevention & control*; D016019:Survival Analysis