JSM 2005 - Toronto

Abstract #304441

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Legend: = Applied Session, = Theme Session, = Presenter
Activity Number: 391
Type: Topic Contributed
Date/Time: Wednesday, August 10, 2005 : 10:30 AM to 12:20 PM
Sponsor: Biometrics Section
Abstract - #304441
Title: Estimation of the Joint Causal Effects on Survival of Multistage Nonrandomized Treatment Sequences for Recurrent Diseases
Author(s): Xuelin Huang*+
Companies: The University of Texas M. D. Anderson Cancer Center
Address: 1515 Holcombe BLVD, Houston, TX, 77030, United States
Keywords: Causal inference ; Estimating equation ; Marginall structure model ; Recurrent event ; Survival analysis ; Treatment strategy
Abstract:

In the treatment of cancer, patients commonly receive a variety of sequential treatments. The initial treatments administered following diagnosis and subsequent salvage regimens given after disease recurrence can vary. This paper considers the situation in which neither initial treatments nor salvage treatments are randomized, but the collected data are sufficiently rich so that it is reasonable to assume there are no unmeasured confounders. The marginal structural models proposed by Robins and colleagues are extended to the recurrent disease situation to estimate the joint causal effects on survival of initial and salvage treatments (i.e., the effects of multistage treatment sequences). Simulation studies are conducted to evaluate the methods. The methods are illustrated by a retrospective study of patients with soft tissue sarcoma, which motivated this research.


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Revised March 2005