Extrapolation before imputation reduces bias when imputing censored covariates

Fuente: arXiv
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Hauptverfasser: Lotspeich, Sarah C., Garcia, Tanya P.
Format: Preprint
Veröffentlicht: 2022
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author Lotspeich, Sarah C.
Garcia, Tanya P.
author_facet Lotspeich, Sarah C.
Garcia, Tanya P.
contents Modeling symptom progression to identify informative subjects for a new Huntington's disease clinical trial is problematic since time to diagnosis, a key covariate, can be heavily censored. Imputation is an appealing strategy where censored covariates are replaced with their conditional means, but existing methods saw over 200% bias under heavy censoring. Calculating these conditional means well requires estimating and then integrating over the survival function of the censored covariate from the censored value to infinity. To estimate the survival function flexibly, existing methods use the semiparametric Cox model with Breslow's estimator, leaving the integrand for the conditional means (the estimated survival function) undefined beyond the observed data. The integral is then estimated up to the largest observed covariate value, and this approximation can cut off the tail of the survival function and lead to severe bias, particularly under heavy censoring. We propose a hybrid approach that splices together the semiparametric survival estimator with a parametric extension, making it possible to approximate the integral up to infinity. In simulation studies, our proposed approach of extrapolation then imputation substantially reduces the bias seen with existing imputation methods, even when the parametric extension was misspecified. We further demonstrate how imputing with corrected conditional means helps to prioritize patients for future clinical trials.
format Preprint
id arxiv_https___arxiv_org_abs_2209_04716
institution arXiv
publishDate 2022
record_format arxiv
spellingShingle Extrapolation before imputation reduces bias when imputing censored covariates
Lotspeich, Sarah C.
Garcia, Tanya P.
Methodology
62J05
Modeling symptom progression to identify informative subjects for a new Huntington's disease clinical trial is problematic since time to diagnosis, a key covariate, can be heavily censored. Imputation is an appealing strategy where censored covariates are replaced with their conditional means, but existing methods saw over 200% bias under heavy censoring. Calculating these conditional means well requires estimating and then integrating over the survival function of the censored covariate from the censored value to infinity. To estimate the survival function flexibly, existing methods use the semiparametric Cox model with Breslow's estimator, leaving the integrand for the conditional means (the estimated survival function) undefined beyond the observed data. The integral is then estimated up to the largest observed covariate value, and this approximation can cut off the tail of the survival function and lead to severe bias, particularly under heavy censoring. We propose a hybrid approach that splices together the semiparametric survival estimator with a parametric extension, making it possible to approximate the integral up to infinity. In simulation studies, our proposed approach of extrapolation then imputation substantially reduces the bias seen with existing imputation methods, even when the parametric extension was misspecified. We further demonstrate how imputing with corrected conditional means helps to prioritize patients for future clinical trials.
title Extrapolation before imputation reduces bias when imputing censored covariates
topic Methodology
62J05
url https://arxiv.org/abs/2209.04716