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目的 介绍部分分布竞争风险模型原理及其在健康风险评估中的应用.方法 介绍部分分布竞争风险模型如何解决慢性病风险评估中的竞争风险问题,进一步结合山东省多中心缺血性脑卒中病例随访队列,阐明部分分布竞争风险模型的实用性.结果 部分分布风险模型充分考虑了竞争风险的影响,将竞争结局融入风险集(risk set)定义,而不是武断地将竞争结局的出现当作删失值处理,其建模效果优于传统的Cox模型.依托山东多中心缺血性脑卒中病例随访队列,将其用于缺血性脑卒中死亡结局风险评估,显示出良好的实用性.结论 部分分布竞争风险模型能够建立协变量和累积发病率函数间的直接关系,较好地处理了健康风险评估的竞争风险问题,具有很强的实用性.“,”Objective To introduce the theory of sub-distribution hazard model and its applications in health risk assessment.Methods Given that competing risks are commonly encountered in health risk assessment,we have introduced the sub-distribution hazard model,and further evaluate itsefficiency and application based on the Shandong Multi-center cohort of hemorrhagic cerebral apoplexy.Results Under the framework of competing risk,the sub-distribution hazard model took the competing endpoint into the construction of the risk set,other than treating the competing endpoint simply as the censoring.Thus,it can have better performance than the traditional Cox model.Based on the Shandong Multi-center cohort of hemorrhagic cerebral apoplexy,it showed a good practicability in risk assessment of stroke death.Conclusion The sub-distribution hazard model can directly link the covariates with the cumulative incidence function,and can efficiently deal with the competing risk problem.