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Martin Wolkewitz

Publications and source records attributed to Martin Wolkewitz.

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A statistical perspective on transformers for small longitudinal cohort data

Modeling of longitudinal cohort data typically involves complex temporal dependencies between multiple variables. There, the transformer architecture, which has been highly successful in language and vision applications, allows us to account for the fact that the most recently observed time points in an individual's history may not always be the most important for the immediate future. This is achieved by assigning attention weights to observations of an individual based on a transformation of their values. One reason why these ideas have not yet been fully leveraged for longitudinal cohort data is that typically, large datasets are required. Therefore, we present a simplified transformer architecture that retains the core attention mechanism while reducing the number of parameters to be estimated, to be more suitable for small datasets with few time points. Guided by a statistical perspective on transformers, we use an autoregressive model as a starting point and incorporate attention as a kernel-based operation with temporal decay, where aggregation of multiple transformer heads, i.e. different candidate weighting schemes, is expressed as accumulating evidence on different types of underlying characteristics of individuals. This also enables a permutation-based statistical testing procedure for identifying contextual patterns. In a simulation study, the approach is shown to recover contextual dependencies even with a small number of individuals and time points. In an application to data from a resilience study, we identify temporal patterns in the dynamics of stress and mental health. This indicates that properly adapted transformers can not only achieve competitive predictive performance, but also uncover complex context dependencies in small data settings.

stat.ME

The population-attributable fraction for time-dependent exposures and competing risks - A discussion on estimands

The population-attributable fraction (PAF) quantifies the public health impact of a harmful exposure. Despite being a measure of significant importance an estimand accommodating complicated time-to-event data is not clearly defined. We discuss current estimands of the PAF used to quantify the public health impact of an internal time-dependent exposure for data subject to competing outcomes. To overcome some limitations, we proposed a novel estimand which is based on dynamic prediction by landmarking. In a profound simulation study, we discuss interpretation and performance of the various estimands and their estimators. The methods are applied to a large French database to estimate the health impact of ventilator-associated pneumonia for patients in intensive care.

stat.AP

The population-attributable fraction for time-dependent exposures using dynamic prediction and landmarking

The public health impact of a harmful exposure can be quantified by the population-attributable fraction (PAF). The PAF describes the attributable risk due to an exposure and is often interpreted as the proportion of preventable cases if the exposure could be extinct. Difficulties in the definition and interpretation of the PAF arise when the exposure of interest depends on time. Then, the definition of exposed and unexposed individuals is not straightforward. We propose dynamic prediction and landmarking to define and estimate a PAF in this data situation. Two estimands are discussed which are based on two hypothetical interventions that could prevent the exposure in different ways. Considering the first estimand, at each landmark the estimation problem is reduced to a time-independent setting. Then, estimation is simply performed by using a generalized-linear model accounting for the current exposure state and further (time-varying) covariates. The second estimand is based on counterfactual outcomes, estimation can be performed using pseudo-values or inverse-probability weights. The approach is explored in a simulation study and applied on two data examples. First, we study a large French database of intensive care unit patients to estimate the population-benefit of a pathogen-specific intervention that could prevent ventilator-associated pneumonia caused by the pathogen Pseudomonas aeruginosa. Moreover, we quantify the population-attributable burden of locoregional and distant recurrence in breast cancer patients.

stat.AP

Causal inference with multi-state models - estimands and estimators of the population-attributable fraction

The population-attributable fraction (PAF) is a popular epidemiological measure for the burden of a harmful exposure within a population. It is often interpreted causally as proportion of preventable cases after an elimination of exposure. Originally, the PAF has been defined for cohort studies of fixed length with a baseline exposure or cross-sectional studies. An extension of the definition to complex time-to-event data is not straightforward. We revise the proposed approaches in literature and provide a clear concept of the PAF for these data situations. The conceptualization is achieved by a proper differentiation between estimands and estimators as well as causal effect measures and measures of association.

stat.ME