Regression analysis for the proportional hazards model with parameter constraints under case-cohort design

A constrained maximum likelihood approach to developing well-calibrated models for predicting binary outcomes

The added value of candidate predictors for risk modeling is routinely evaluated by comparing the performance of models with or without including candidate predictors. Such comparison is most meaningful when the estimated risk by the two models are both unbiased in the target population. Very often data for candidate predictors are sourced from nonrepresentative convenience samples. Updating the base model using the study data without acknowledging the discrepancy between the underlying distribution of the study data and that in the target population can lead to biased risk estimates and therefore an unfair evaluation of candidate predictors. To address this issue assuming access to a well-calibrated base model, we propose a semiparametric method for model fitting that enforces good calibration. The central idea is to calibrate the fitted model against the base model by enforcing suitable constraints in maximizing the likelihood function. This approach enables unbiased assessment of model improvement offered by candidate predictors without requiring a representative sample from the target population, thus overcoming a significant practical challenge. We study theoretical properties for model parameter estimates, and demonstrate improvement in model calibration via extensive simulation studies. Finally, we apply the proposed method to data extracted from Penn Medicine Biobank to inform the added value of breast density for breast cancer risk assessment in the Caucasian woman population.

A class of goodness-of-fit test for the additive hazards model with case-cohort data

The case-cohort design is commonly used in epidemiological studies due to its cost-effectiveness. The additive hazards model is widely used in survival analysis when the hazards difference is constant. In this article, we propose a class of goodness-of-fit test statistics for the assumption of the additive hazards model with case-cohort data through a class of asymptotically mean-zero multiparameter stochastic processes. We also establish the asymptotic theory of the proposed test statistics and a resampling scheme is adopted to approximate its asymptotic distribution. The performance of the proposed test statistics is evaluated through simulation studies and a real dataset is analyzed to illustrate the proposed method.