title: Analysis of failure time hierarchical data in the presence of competing risks with application to oral contraceptive pill use in Egypt.
abstract: Problems of practical interest in the analysis of data on contraceptive use, from Demographic and Health Surveys (DHS), include the estimation of the cause-specific probability of discontinuation by time t (the cumulative incidence function), in the presence of other competing causes and the evaluation of the effect of covariates on the cause-specific hazards of discontinuation. Methods of analysis of failure time data with competing risks are by now fairly well developed in the case of a simple random sample. However, the data from the DHS are clustered by geographical areas and include multiple episodes per woman. For a marginal (population average) approach, we propose using methods developed for simple random samples with standard errors calculated using a double bootstrap to take account of the clustered hierarchical nature of the data. In the conditional approach, the cause-specific hazards are modelled as log-linear functions of the covariates conditional on random effects of clusters and women, using a three-level multinomial discrete-time logit model. The methods are applied to data from Egypt 1992 DHS on the oral contraceptive pill use.
authors.affiliation: Centre for Population Studies, London School of Hygiene & Tropical Medicine, 49-51 Bedford Square, London WC1B 3DP, UK. mohaned.ali@lshtm.ac.uk
authors.forename: M M
authors.initials: MM
authors.lastname: Ali
authors.forename: A G
authors.initials: AG
authors.lastname: Babiker
authors.forename: J G
authors.initials: JG
authors.lastname: Cleland
mesh_terms: D000293:Adolescent; D000328:Adult; D016000:Cluster Analysis; D003267:Contraception / Q000379:methods* / Q000592:standards; D003271:Contraceptive Agents, Female; D003278:Contraceptives, Oral, Hormonal; D004534:Egypt; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D008954:Models, Biological; D011247:Pregnancy; D012307:Risk Factors
chemical_list: D003271:Contraceptive Agents, Female; D003278:Contraceptives, Oral, Hormonal