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PH6415 Review Questions. Question 1. A journal article reports a 95%CI for the relative risk (RR) of an event (treatment versus control as (0.55, 0.97). What can be said of the p-value associated with testing Ho: RR=1 vs. Ha: RR not equal 1? The p-value is < 0.01. The p-value is < 0.05.
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Question 1 • A journal article reports a 95%CI for the relative risk (RR) of an event (treatment versus control as (0.55, 0.97). What can be said of the p-value associated with testing Ho: RR=1 vs. Ha: RR not equal 1? • The p-value is < 0.01. • The p-value is < 0.05. • The p-value is > 0.05 • No statement can be said about the p-value.
Question 2 • If S (t) is the survival function and t is in years what is the meaning of S(3) . • The probability of dying at year 3. • The probability of surviving to year 3. • The probability of dying by year 3 • The hazard of dying at year 3.
Question 3 • In logistic regression with a continuous variable age what is the meaning of b1 ? • The difference in log odds between two persons 1 year apart in age • The relative odds between two persons 1 year apart in age • The difference in probabilities between two persons 1 year apart in age
Question 4 • If the probability of developing diabetes is 0.20 among Hispanics and 0.15 among whites, what is the relative odds (Hispanics v white) of developing diabetes. • 1.42 • 0.70 • 0.75 • 1.33
Question 5 • Suppose the logistic regression model: log odds = b0 + b1X1 + b2X2 +b3X1*X2 where X1 is an indicator for treatment and X2 is an indicator for male gender. The relative odds (treatment versus no treatment) for women is: • exp(b1) • exp(b2) • exp(b1 + b3) • Exp( b1 - b3)
Question 6 • The probability and odds of an event will be nearly equal if: • The probability of the event is small • The probability of the event is large • The probability of the event is 0.50
Cox Proportional Hazards Regression in SAS A Review Goto:www.biostat.umn.edu/~susant/PH6415DATA.html • C • Read uis.readme file on website. • Input data from uis (SAS data set) • Use Proc Lifetest to plot the Kaplan-Meier Curve for each categorical predictor separately. Look to see if the survival curves are approximately parallel and if there appears to be a difference in survival. • Use Proc PHREG to with model containing age, number of previous drug treatments, treatment and site.
Cox Proportional Hazards Regression in SAS A Review • C • Consider the interaction between age and site. Is this interaction significant? • Consider the final model of age, number of previous drug treatments, site and age_site.
Questions About the Survival Curves • What does the log-rank test of equality across strata indicate for the survival curves of the short and long treatment programs? • What does the log-rank test of equality across strata indicate for the survival curves of the two different sites? Why might the p-value for the log-rank test be inflated? • What does the log-rank test of equality across strata indicate for the three combinations of heroine and cocaine use? Do the curves overlap?
Questions about Survival Data • What is the median time to relapse for those at site A? What is the median time to relapse for those at site B? • How many people relapsed at site A? What percent of site A relapsed? How many people relapse at site B? What percent of site B relapsed? • When did the first person relapse at site A? When did the first person relapse at site B?
Questions about Censoring • What percent of people where censored in the long treatment program compared to the short treatment? • For both treatment groups, does that censoring appear to be patients who do not relapse or patients who are loss to follow-up?
Questions about parameters in Cox Proportional Hazards • What is the relative risk of relapse for a one unit increase in previous drug treatments if all other variables are held constant? This represents a ________ percent increase in rate of relapse. • If treatment length is altered from short(trt =0) to long (trt=1), while holding all other variables constant, the rate of relapse decreases by ______ percent. (RR of trt=1/trt=0).
Considering Interactions in Cox Proportional Hazards • What is the relative risk of relapse for a person who is 30 compared to 25 if they are at site A (site=0) with all other variables held constant? This translates to a _____ percent decrease in rate of relapse. • What is the relative risk of relapse for a person who is 30 compared to 25 if they are at site B (site=1) with all other variables held constant? This translates to a _____ percent decrease in relapse. • Is this difference in rate of relapse for a five year increase in age between the two sites significant?
Logistic Regression Review • Can age, educational level and gender (female=1) predict the odds that someone votes for a particular candidate? Let p= proportion of voters who vote for candidate “Superman”. • Model:
Logistic Regression Review • The following is a sample of logistic output:
Questions for Logistic • What is the equation of the estimated Log(odds)? • What do we predict the odds to be for a 35 year-old male with 16 years of school? • What is the probability a 35 year-old male with 16 years of school will vote for “Superman”? • What is the odds a woman will vote for “Superman” compared to a man (all other covariates held fixed)?
TOMHS Example • Question: Does the effect of active blood pressure treatment on CVD differ for young versus older persons? • Looking at an interaction effect (effect modification) • Compare • Odds CVD (treatment/placebo) in younger patients • Odds CVD (treatment/placebo) in older patients
Logistic Model For Interaction X1 = 1 for active treatment and 0 for placebo X2 = 1 for age ≥ 55 and 0 for age < 55 X3 = X1 * X2 So, X3 = 1 for active treatment and age > 55 X3 = all other combinations.
Log Odds (placebo, young) = b0 Log Odds (active, young) = b0 + b1 Log Odds (placebo, old) = b0 + b2 Log Odds (active, old) = b0 + b1 + b2 + b3 Dif = b1; exp(b1) is odds (A v P) for young Dif = b1 + b3; exp(b1 + b3 ) is odds (A v P) for old Logistic Model For Interaction X1 = 1 for active treatment and 0 for placebo X2 = 1 for age ≥ 55 and 0 for age < 55 X3 = X1 * X2
Log Odds (placebo, young) = b0 Log Odds (active, young) = b0 + b1 Log Odds (placebo, old) = b0 + b2 Log Odds (active, old) = b0 + b1 + b2 + b3 exp(b1) is odds (A v P) for young exp(b1 + b3 ) is odds (A v P) for old Odds (A v P) for Old exp(b1 + b3) exp (b3) = Odds (A v P) for Young exp (b1) What does b3 Mean? = A ratio of ratios!!
Interaction Hypothesis Q: Does the effect of active treatment on CVD differ for young versus older persons? Ho: b3 = 0 Ha: b3≠ 0 Test in SAS just like any other coefficient
The LOGISTIC Procedure Analysis of Maximum Likelihood Estimates Standard Wald Parameter DF Estimate Error Chi-Square Pr > ChiSq Intercept 1 -1.6843 0.2566 43.0730 <.0001 active 1 -0.8806 0.3301 7.1180 0.0076 old 1 0.0850 0.3549 0.0573 0.8108 active_old 1 0.7771 0.4395 3.1261 0.0770 Odds Ratio Estimates Point 95% Wald Effect Estimate Confidence Limits active 0.415 0.217 0.792 old 1.089 0.543 2.183 active_old 2.175 0.919 5.147 b1 b2 b3 2.175 = 0.90/.415 Ratio of Odds Ratios Odds CVD (A v P) for younger patients = exp(b1) = 0.415 Odds CVD (A v P) for older patients = exp(b1 + b3) = exp(-0.11) = 0.90
Description of Findings In patients < age 55 the CVD risk was 58% lower in the active treatment (OR: 0.42) – Exp(b1) For patients over 55 years of age the CVD risk was only 10% lower (OR:.90). - Exp(b1+b3) The test for interaction between treatment and age approached significance (p=.07).