An Adaptive Approach for Hazard Regression Modeling

Abstract

Regression models for survival time data involve estimation of the hazard rate as a function of predictor variables and associated slope parameters. An adaptive approach is formulated for such hazard regression modeling. The hazard rate is modeled using fractional polynomials, that is, linear combinations of products of power transforms of time together with other available predictors. These fractional polynomial models are restricted to generating positive-valued hazard rates and decreasing survival times. Exponentially distributed survival times are a special case. Parameters are estimated using maximum likelihood estimation allowing for right censored survival times. Models are evaluated and compared using likelihood cross-validation (LCV) scores. LCV scores and tolerance parameters are used to control an adaptive search through alternative fractional polynomial hazard rate models to identify ef fective models for the underlying survival time data. These methods are demonstrated using two different survival time data sets including survival times for lung cancer patients and for multiple myeloma patients. For the lung cancer data, the hazard rate depends distinctly on time. However, controlling for cell type provides a distinct improvement while the hazard rate depends only on cell type and no longer on time. Furthermore, Cox regression is unable to identify a cell type effect. For the multiple myeloma data, the hazard rate also depends distinctly on time. Moreover, consideration of hemoglobin at diagnosis provides a distinct improvement, the hazard rate still depends distinctly on time, and hemoglobin distinctly moderates the effect of time on the hazard rate. These results indicate that adaptive hazard rate modeling can provide unique insights into survival time data.