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Rebecca Farina

Publications and source records attributed to Rebecca Farina.

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Doubly Robust and Efficient Calibration of Prediction Sets for Right-Censored Time-to-Event Outcomes

Our objective is to construct well-calibrated prediction sets for a time-to-event outcome subject to right-censoring with guaranteed coverage. Inspired by modern conformal inference, our approach avoids the need for a well-specified parametric or semiparametric survival model. Unlike existing conformal methods for survival data, which assume Type-I censoring with fully observed censoring times, we consider the more common right-censoring setting in which only the censoring time or only the event time is observed, whichever comes first. Under a standard conditional independence censoring condition, we propose and analyze several lower prediction bounds for the survival time of a future observation, including inverse-probability-of-censoring weighting, and its augmented version based on the semiparametric efficient influence function for the relevant marginal quantile of the outcome accounting for dependent censoring. We formally establish asymptotic coverage guarantees of the proposed methods, and demonstrate both theoretically and through empirical experiments, that the augmented approach substantially improves efficiency over all other proposed methods. Specifically, its coverage error bound is doubly robust, and therefore of second order, thus ensuring that it is asymptotically negligible relative to the coverage error of the other methods.

stat.ME

Dynamic Prediction for Hospital Readmission in Patients with Chronic Heart Failure

Hospital readmission among patients with chronic heart failure (HF) is a major clinical and economic burden. Dynamic prediction models that leverage longitudinal biomarkers may improve risk stratification over traditional static models. This study aims to develop and validate a joint model using longitudinal N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurements to predict the risk of rehospitalization or death in HF patients. We analyzed real-world data from the TriNetX database, including patients with an incident HF diagnosis between 2016 and 2022. The final selected cohort included 1,804 patients. A Bayesian joint modeling framework was developed to link patient-specific NT-proBNP trajectories to the risk of a composite endpoint (HF rehospitalization or all-cause mortality) within a 180-day window following hospital discharge. The model's performance was evaluated using 5-fold cross-validation and assessed with the Integrated Brier Score and Integrated Calibration Index. The joint model demonstrated a strong predictive advantage over a benchmark static model, particularly when making updated predictions at later time points (180-360 days). A joint model trained on patients with more frequent NT-proBNP measurements achieved the highest accuracy. The main joint model showed excellent calibration, suggesting its risk estimates are reliable. Our findings suggest that modeling the full trajectory of NT-proBNP with a joint modeling framework enables more accurate and dynamic risk assessment compared to static, single-timepoint methods. This approach supports the development of adaptive clinical decision-support tools for personalized HF management.

stat.AP