Correcting for the dependent competing risk of treatment using inverse probability of censoring weighting and copulas in the estimation of natural conception chances.

Abstract:

:When estimating the probability of natural conception from observational data on couples with an unfulfilled child wish, the start of assisted reproductive therapy (ART) is a competing event that cannot be assumed to be independent of natural conception. In clinical practice, interest lies in the probability of natural conception in the absence of ART, as this probability determines the need for therapy. We thus want to estimate the marginal cumulative pregnancy distribution. Without assumptions on the dependence structure between the two competing events, this marginal distribution is not identifiable. We first use inverse probability of censoring weighting assuming that the factors influencing the choice to start ART are known. Then, we parameterize the event distributions for conception and for start of ART and use copulas to account for the dependency between both events. By using these two ways of correcting for the dependent risk of treatment, we obtain a plausible estimation region for the cumulative pregnancy curve and for the prognostic effect of tubal tests.

journal_name

Stat Med

journal_title

Statistics in medicine

authors

van Geloven N,Geskus RB,Mol BW,Zwinderman AH

doi

10.1002/sim.6280

subject

Has Abstract

pub_date

2014-11-20 00:00:00

pages

4671-80

issue

26

eissn

0277-6715

issn

1097-0258

journal_volume

33

pub_type

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