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Pamela A. Shaw

Publications and source records attributed to Pamela A. Shaw.

26 records · Page 2Linked to original sources

Optimum Allocation for Adaptive Multi-Wave Sampling in R: The R Package optimall

The R package optimall offers a collection of functions that efficiently streamline the design process of sampling in surveys ranging from simple to complex. The package's main functions allow users to interactively define and adjust strata cut points based on values or quantiles of auxiliary covariates, adaptively calculate the optimum number of samples to allocate to each stratum using Neyman or Wright allocation, and select specific IDs to sample based on a stratified sampling design. Using real-life epidemiological study examples, we demonstrate how optimall facilitates an efficient workflow for the design and implementation of surveys in R. Although tailored towards multi-wave sampling under two- or three-phase designs, the R package optimall may be useful for any sampling survey.

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An Approximate Quasi-Likelihood Approach for Error-Prone Failure Time Outcomes and Exposures

Measurement error arises commonly in clinical research settings that rely on data from electronic health records or large observational cohorts. In particular, self-reported outcomes are typical in cohort studies for chronic diseases such as diabetes in order to avoid the burden of expensive diagnostic tests. Dietary intake, which is also commonly collected by self-report and subject to measurement error, is a major factor linked to diabetes and other chronic diseases. These errors can bias exposure-disease associations that ultimately can mislead clinical decision-making. We have extended an existing semiparametric likelihood-based method for handling error-prone, discrete failure time outcomes to also address covariate error. We conduct an extensive numerical study to compare the proposed method to the naive approach that ignores measurement error in terms of bias and efficiency in the estimation of the regression parameter of interest. In all settings considered, the proposed method showed minimal bias and maintained coverage probability, thus outperforming the naive analysis which showed extreme bias and low coverage. This method is applied to data from the Women's Health Initiative to assess the association between energy and protein intake and the risk of incident diabetes mellitus. Our results show that correcting for errors in both the self-reported outcome and dietary exposures leads to considerably different hazard ratio estimates than those from analyses that ignore measurement error, which demonstrates the importance of correcting for both outcome and covariate error. Computational details and R code for implementing the proposed method are presented in Section S1 of the Supplementary Materials.

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Improved Generalized Raking Estimators to Address Dependent Covariate and Failure-Time Outcome Error

Biomedical studies that use electronic health records (EHR) data for inference are often subject to bias due to measurement error. The measurement error present in EHR data is typically complex, consisting of errors of unknown functional form in covariates and the outcome, which can be dependent. To address the bias resulting from such errors, generalized raking has recently been proposed as a robust method that yields consistent estimates without the need to model the error structure. We provide rationale for why these previously proposed raking estimators can be expected to be inefficient in failure-time outcome settings involving misclassification of the event indicator. We propose raking estimators that utilize multiple imputation, to impute either the target variables or auxiliary variables, to improve the efficiency. We also consider outcome-dependent sampling designs and investigate their impact on the efficiency of the raking estimators, either with or without multiple imputation. We present an extensive numerical study to examine the performance of the proposed estimators across various measurement error settings. We then apply the proposed methods to our motivating setting, in which we seek to analyze HIV outcomes in an observational cohort with electronic health records data from the Vanderbilt Comprehensive Care Clinic.

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Combining multiple imputation with raking of weights: An efficient and robust approach in the setting of nearly-true models

Multiple imputation provides us with efficient estimators in model-based methods for handling missing data under the true model. It is also well-understood that design-based estimators are robust methods that do not require accurately modeling the missing data; however, they can be inefficient. In any applied setting, it is difficult to know whether a missing data model may be good enough to win the bias-efficiency trade-off. Raking of weights is one approach that relies on constructing an auxiliary variable from data observed on the full cohort, which is then used to adjust the weights for the usual Horvitz-Thompson estimator. Computing the optimally efficient raking estimator requires evaluating the expectation of the efficient score given the full cohort data, which is generally infeasible. We demonstrate multiple imputation (MI) as a practical method to compute a raking estimator that will be optimal. We compare this estimator to common parametric and semi-parametric estimators, including standard multiple imputation. We show that while estimators, such as the semi-parametric maximum likelihood and MI estimator, obtain optimal performance under the true model, the proposed raking estimator utilizing MI maintains a better robustness-efficiency trade-off even under mild model misspecification. We also show that the standard raking estimator, without MI, is often competitive with the optimal raking estimator. We demonstrate these properties through several numerical examples and provide a theoretical discussion of conditions for asymptotically superior relative efficiency of the proposed raking estimator.

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Two-phase analysis and study design for survival models with error-prone exposures

Increasingly, medical research is dependent on data collected for non-research purposes, such as electronic health records data (EHR). EHR data and other large databases can be prone to measurement error in key exposures, and unadjusted analyses of error-prone data can bias study results. Validating a subset of records is a cost-effective way of gaining information on the error structure, which in turn can be used to adjust analyses for this error and improve inference. We extend the mean score method for the two-phase analysis of discrete-time survival models, which uses the unvalidated covariates as auxiliary variables that act as surrogates for the unobserved true exposures. This method relies on a two-phase sampling design and an estimation approach that preserves the consistency of complete case regression parameter estimates in the validated subset, with increased precision leveraged from the auxiliary data. Furthermore, we develop optimal sampling strategies which minimize the variance of the mean score estimator for a target exposure under a fixed cost constraint. We consider the setting where an internal pilot is necessary for the optimal design so that the phase two sample is split into a pilot and an adaptive optimal sample. Through simulations and data example, we evaluate efficiency gains of the mean score estimator using the derived optimal validation design compared to balanced and simple random sampling for the phase two sample. We also empirically explore efficiency gains that the proposed discrete optimal design can provide for the Cox proportional hazards model in the setting of a continuous-time survival outcome.

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Raking and Regression Calibration: Methods to Address Bias from Correlated Covariate and Time-to-Event Error

Medical studies that depend on electronic health records (EHR) data are often subject to measurement error, as the data are not collected to support research questions under study. These data errors, if not accounted for in study analyses, can obscure or cause spurious associations between patient exposures and disease risk. Methodology to address covariate measurement error has been well developed; however, time-to-event error has also been shown to cause significant bias but methods to address it are relatively underdeveloped. More generally, it is possible to observe errors in both the covariate and the time-to-event outcome that are correlated. We propose regression calibration (RC) estimators to simultaneously address correlated error in the covariates and the censored event time. Although RC can perform well in many settings with covariate measurement error, it is biased for nonlinear regression models, such as the Cox model. Thus, we additionally propose raking estimators which are consistent estimators of the parameter defined by the population estimating equation. Raking can improve upon RC in certain settings with failure-time data, require no explicit modeling of the error structure, and can be utilized under outcome-dependent sampling designs. We discuss features of the underlying estimation problem that affect the degree of improvement the raking estimator has over the RC approach. Detailed simulation studies are presented to examine the performance of the proposed estimators under varying levels of signal, error, and censoring. The methodology is illustrated on observational EHR data on HIV outcomes from the Vanderbilt Comprehensive Care Clinic.

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Regression to the Mean's Impact on the Synthetic Control Method: Bias and Sensitivity Analysis

To make informed policy recommendations from observational data, we must be able to discern true treatment effects from random noise and effects due to confounding. Difference-in-Difference techniques which match treated units to control units based on pre-treatment outcomes, such as the synthetic control approach have been presented as principled methods to account for confounding. However, we show that use of synthetic controls or other matching procedures can introduce regression to the mean (RTM) bias into estimates of the average treatment effect on the treated. Through simulations, we show RTM bias can lead to inflated type I error rates as well as decreased power in typical policy evaluation settings. Further, we provide a novel correction for RTM bias which can reduce bias and attain appropriate type I error rates. This correction can be used to perform a sensitivity analysis which determines how results may be affected by RTM. We use our proposed correction and sensitivity analysis to reanalyze data concerning the effects of California's Proposition 99, a large-scale tobacco control program, on statewide smoking rates.

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Epidemiologic analyses with error-prone exposures: Review of current practice and recommendations

Background: Variables in epidemiological observational studies are commonly subject to measurement error and misclassification, but the impact of such errors is frequently not appreciated or ignored. As part of the STRengthening Analytical Thinking for Observational Studies (STRATOS) Initiative, a Task Group on measurement error and misclassification (TG4) seeks to describe the scope of this problem and the analysis methods currently in use to address measurement error. Methods: TG4 conducted a literature survey of four types of research studies that are typically impacted by exposure measurement error: 1) dietary intake cohort studies, 2) dietary intake population surveys, 3) physical activity cohort studies, and 4) air pollution cohort studies. The survey was conducted to understand current practice for acknowledging and addressing measurement error. Results: The survey revealed that while researchers were generally aware that measurement error affected their studies, very few adjusted their analysis for the error. Most articles provided incomplete discussion of the potential effects of measurement error on their results. Regression calibration was the most widely used method of adjustment. Conclusions: Even in areas of epidemiology where measurement error is a known problem, the dominant current practice is to ignore errors in analyses. Methods to correct for measurement error are available but require additional data to inform the error structure. There is a great need to incorporate such data collection within study designs and improve the analytical approach. Increased efforts by investigators, editors and reviewers are also needed to improve presentation of research when data are subject to error.

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