title: Association analysis of successive events data in the presence of competing risks.
abstract: We aim to close a methodological gap in analyzing durations of successive events that are subject to induced dependent censoring as well as competing-risk censoring. In the Bipolar Disorder Center for Pennsylvanians study, some patients who managed to recover from their symptomatic entry later developed a new depressive or manic episode. It is of great clinical interest to quantify the association between time to recovery and time to recurrence in patients with bipolar disorder. The estimation of the bivariate distribution of the gap times with independent censoring has been well studied. However, the existing methods cannot be applied to failure times that are censored by competing causes such as in the Bipolar Disorder Center for Pennsylvanians study. Bivariate cumulative incidence function has been used to describe the joint distribution of parallel event times that involve multiple causes. To the best of our knowledge, however, there is no method available for successive events with competing-risk censoring. Therefore, we extend the bivariate cumulative incidence function to successive events data, and propose non-parametric estimators of the bivariate cumulative incidence function and the related conditional cumulative incidence function. Moreover, an odds ratio measure is proposed to describe the cause-specific dependence, leading to the development of a formal test for independence of successive events. Simulation studies demonstrate that the estimators and tests perform well for realistic sample sizes, and our methods can be readily applied to the Bipolar Disorder Center for Pennsylvanians study.
authors.affiliation: 1 Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Xiaotian
authors.initials: X
authors.lastname: Chen
authors.affiliation: 1 Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA.|2 Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA.
authors.forename: Yu
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: 2 Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Frank
authors.affiliation: 2 Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Kupfer
mesh_terms: D000465:Algorithms; D001714:Bipolar Disorder / Q000534:rehabilitation; D006801:Humans; D015233:Models, Statistical; D011336:Probability; D012008:Recurrence; D018570:Risk Assessment / Q000706:statistics & numerical data
keywords: Bivariate cumulative incidence function; bipolar disorder; competing risks; inverse probability weighting; odds ratio; successive events