Abstract:
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A specific aim of a cancer survivorship program is to classify the survivors according to whether they are at the risk to the consequences of the initial cancer diagnosis. To achieve the goal, we adapt the GEE approach to analyze the longitudinal physician visit claims collected for a young cancer survivor cohort with latent class mean-variance models. The physician visit claims from a subset of the cohort, in which subjects are identified at the baseline and generally viewed as suffering the consequences, are used to quantify the characteristics for "at-risk" in physician visit frequency or cost. On the other hand, the claims from a selected group of the general population, matching the cohort in sex and birth-year, set the standard of "not-at-risk". These enable our approach easy to implement and efficient in inference, while enjoying the inherent robustness of the GEE approach. We validate the classification via a fitted latent class mean-variance model using another subset of the cohort, presenting late effects of the initial diagnosis during the follow-up period.
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