My principal aim is further development of new methods for analyzing observational data bases and randomized trials of HIV-infected persons. The proposed approaches are based either on (i) the estimation of a new class of causal models, the structural nested models using a new class of estimators, the G-estimators, or (ii) new methods for analyzing semi- or non-parametric models in the presence of both informative and non- informative missing data. Many of the new methods are fundamentally """"""""epidemiologic"""""""" in that they require data on time-dependent confounding factors, that is, risk factors for outcomes that also predict subsequent treatment with the drug or co-factor under study. The proposed methods of analysis will improve upon previous methods in the following ways. First, the new methods are the best methods available to estimate the effect of a treatment (e.g., AZT) or a co-factor (e.g., marijuana) on an outcome of interest (e.g., time to AIDS or CD4-count level) from observational data available, when symptoms of HIV disease (e.g., thrush, fever) are simultaneously confounders and intermediate variables. We shall use the new methods to estimate treatment and co-factor effects on the evolution of CD4-counts and on time to progression of HIV-disease among subjects in the San Francisco Men's Health Study (SFMHS), and the Multicenter AIDS Cohort Study (MACS). Results will be compared with results obtained using standard methods. Second, the new methods are the best methods available to adjust for dependent censoring, non-random non-compliance, treatment cross-over or termination, and the concurrent effect of additional non-randomized treatments in randomized clinical trials. For example, in ACTG trial 002 of the effect of high-dose versus low-dose AZT on the survival of AIDS patients, patients in the low-dose arm took more aerosolized pentamidine (a non-randomized treatment). The new methods are the best methods available to efficiently incorporate information on surrogate markers (e.g., CD4-count) in order to stop, at the earliest possible moment, randomized trials of the effect of a treatment on a survival time outcome (e.g., time to AIDS). Specifically, we to construct a valid alpha-level test of the null hypothesis of no effect of treatment on survival that incorporates data on the evolution of multivariate surrogate markers, e.g., (CD4-count and HIV antigen level), with power exceeding that of the log rank test. We shall use our new methods to further analyze ACTG trial 0002 as well as ACTG trials 021 and 081. These latter two trials compare the effects of various chemotherapeutic agents on the opportunistic infection and survival experience of HIV-infected subjects.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
5R01AI032475-06
Application #
2457747
Study Section
AIDS and Related Research Study Section 2 (ARRB)
Project Start
1992-08-01
Project End
1998-07-31
Budget Start
1997-08-01
Budget End
1998-07-31
Support Year
6
Fiscal Year
1997
Total Cost
Indirect Cost
Name
Harvard University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
082359691
City
Boston
State
MA
Country
United States
Zip Code
02115
Richardson, Thomas S; Robins, James M; Wang, Linbo (2018) Discussion of ""Data-driven confounder selection via Markov and Bayesian networks"" by Häggström. Biometrics 74:403-406
Wang, Linbo; Richardson, Thomas S; Zhou, Xiao-Hua (2017) Causal analysis of ordinal treatments and binary outcomes under truncation by death. J R Stat Soc Series B Stat Methodol 79:719-735
Evans, R J; Forcina, A (2013) Two algorithms for fitting constrained marginal models. Comput Stat Data Anal 66:1-7
Evans, Robin J; Richardson, Thomas S (2013) Marginal log-linear parameters for graphical Markov models. J R Stat Soc Series B Stat Methodol 75:743-768
Page, John H; Rotnitzky, Andrea (2009) Estimation of the disease-specific diagnostic marker distribution under verification bias. Comput Stat Data Anal 53:707-717
Moodie, Erica E M; Richardson, Thomas S (2009) Estimating Optimal Dynamic Regimes: Correcting Bias under the Null: [Optimal dynamic regimes: bias correction]. Scand Stat Theory Appl 37:126-146
Shardell, Michelle; Scharfstein, Daniel O; Vlahov, David et al. (2008) Inference for cumulative incidence functions with informatively coarsened discrete event-time data. Stat Med 27:5861-79
Moodie, Erica E M; Richardson, Thomas S; Stephens, David A (2007) Demystifying optimal dynamic treatment regimes. Biometrics 63:447-55
Scharfstein, Daniel O; Halloran, M Elizabeth; Chu, Haitao et al. (2006) On estimation of vaccine efficacy using validation samples with selection bias. Biostatistics 7:615-29
Hernan, Miguel A; Lanoy, Emilie; Costagliola, Dominique et al. (2006) Comparison of dynamic treatment regimes via inverse probability weighting. Basic Clin Pharmacol Toxicol 98:237-42

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