Modeling Sequential Dependence in Recurrent Event Data
摘要
In an observational study using data from Kaiser Permanente Northern California (KPNC), we evaluated the effectiveness of respiratory syncytial virus (RSV) immunoprophylaxis palivizumab, a monthly injection that eligible infants receive during the winter RSV season, on RSV-related morbidity, particularly recurrent bronchiolitis in infancy. Traditional methods such as extended Cox Proportional Hazards (CPH) models are commonly used to analyze these recurrent event data. We propose a new approach based on the nonhomogeneous Poisson process that explicitly models the impact of a past event episode and a time-varying treatment on the likelihood of future episodes of the event. Two models, the common-hazard and distinct-hazard models, are developed. These models and the extended CPH model are evaluated in simulation studies and applied to the KPNC dataset.