Dear All,
I would be grateful to you if you could help me with the following. I am doing a cox regression analysis regarding patient survival after kidney transplantation aiming to explore the effect of NODAT. Most of the papers report one of the following: 1. They do univariate analysis and then proceed with multivariate cox regression analysis including only variables which were significant in the univariate analysis. They do not report about assumptions. 2. They include in the model all the variables which did not violate the PH assumptions. Which approach is considered the ideal one? Thank you in advance, Dimitris |
Hi Dimitrios:
First approach is definitely WRONG. Take a look at the paper "Inappropriate Use of Bivariable Analysis to Screen Risk Factors for Use in Multivariable Analysis", J Clin Epidemiol Vol. 49, No. 8, pp. 907-916, 1996. Regarding the second approach, you should include ALL relevant variables: known risk factors of death in kidney transplanted patients, age & gender as usual suspects, other potential confounders, effect modifiers ("is the effect of NODAT on survival modified by other factors?")... If any of them violate the PH assumption, there are statistical methods to control that (stratification, time-dependent covariate Cox model...), but an important predictor should not be left out of the model just because the PH assumption is not met. Regression models are built for two main purposes: prediction and explanation (see "To Explain or to Predict?", Statistical Science 2010, Vol. 25, No. 3, 289–310). You should know what type of model you are trying to build before attempting to construct it. HTH, Marta GG El 16/04/2014 13:22, dimitrios escribió: > Dear All, > > I would be grateful to you if you could help me with the following. > > I am doing a cox regression analysis regarding patient survival after kidney > transplantation aiming to explore the effect of NODAT. > > Most of the papers report one of the following: > > 1. They do univariate analysis and then proceed with multivariate cox > regression analysis including only variables which were significant in the > univariate analysis. They do not report about assumptions. > > 2. They include in the model all the variables which did not violate the PH > assumptions. > > Which approach is considered the ideal one? > > Thank you in advance, > Dimitris > > > > -- > View this message in context: http://spssx-discussion.1045642.n5.nabble.com/Cox-regression-analysis-question-tp5725476.html > Sent from the SPSSX Discussion mailing list archive at Nabble.com. > > ===================== > To manage your subscription to SPSSX-L, send a message to > [hidden email] (not to SPSSX-L), with no body text except the > command. To leave the list, send the command > SIGNOFF SPSSX-L > For a list of commands to manage subscriptions, send the command > INFO REFCARD > ===================== To manage your subscription to SPSSX-L, send a message to [hidden email] (not to SPSSX-L), with no body text except the command. To leave the list, send the command SIGNOFF SPSSX-L For a list of commands to manage subscriptions, send the command INFO REFCARD |
In reply to this post by dimitrios
I forgot to add a must-read: Mitchell Katz "Multivariable Analysis: A
Primer for Readers of Medical Research", Ann Intern Med. 2003;138:644-650. Regards, MGG El 16/04/2014 13:22, dimitrios escribió: > Dear All, > > I would be grateful to you if you could help me with the following. > > I am doing a cox regression analysis regarding patient survival after kidney > transplantation aiming to explore the effect of NODAT. > > Most of the papers report one of the following: > > 1. They do univariate analysis and then proceed with multivariate cox > regression analysis including only variables which were significant in the > univariate analysis. They do not report about assumptions. > > 2. They include in the model all the variables which did not violate the PH > assumptions. > > Which approach is considered the ideal one? > > Thank you in advance, > Dimitris > > > > -- > View this message in context: http://spssx-discussion.1045642.n5.nabble.com/Cox-regression-analysis-question-tp5725476.html > Sent from the SPSSX Discussion mailing list archive at Nabble.com. > > ===================== > To manage your subscription to SPSSX-L, send a message to > [hidden email] (not to SPSSX-L), with no body text except the > command. To leave the list, send the command > SIGNOFF SPSSX-L > For a list of commands to manage subscriptions, send the command > INFO REFCARD > ===================== To manage your subscription to SPSSX-L, send a message to [hidden email] (not to SPSSX-L), with no body text except the command. To leave the list, send the command SIGNOFF SPSSX-L For a list of commands to manage subscriptions, send the command INFO REFCARD |
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