edoc

Modeling multi-level survival data in multi-center epidemiological cohort studies: applications from the ELAPSE project

Samoli, E. and Rodopoulou, S. and Hvidtfeldt, U. A. and Wolf, K. and Stafoggia, M. and Brunekreef, B. and Strak, M. and Chen, J. and Andersen, Z. J. and Atkinson, R. and Bauwelinck, M. and Bellander, T. and Brandt, J. and Cesaroni, G. and Forastiere, F. and Fecht, D. and Gulliver, J. and Hertel, O. and Hoffmann, B. and de Hoogh, K. and Janssen, N. A. H. and Ketzel, M. and Klompmaker, J. O. and Liu, S. and Ljungman, P. and Nagel, G. and Oftedal, B. and Pershagen, G. and Peters, A. and Raaschou-Nielsen, O. and Renzi, M. and Kristoffersen, D. T. and Severi, G. and Sigsgaard, T. and Vienneau, D. and Weinmayr, G. and Hoek, G. and Katsouyanni, K.. (2021) Modeling multi-level survival data in multi-center epidemiological cohort studies: applications from the ELAPSE project. Environment international, 147. p. 106371.

[img] PDF - Published Version
Available under License CC BY-NC-ND (Attribution-NonCommercial-NoDerivatives).

685Kb

Official URL: https://edoc.unibas.ch/89366/

Downloads: Statistics Overview

Abstract

BACKGROUND: We evaluated methods for the analysis of multi-level survival data using a pooled dataset of 14 cohorts participating in the ELAPSE project investigating associations between residential exposure to low levels of air pollution (PM2.5 and NO2) and health (natural-cause mortality and cerebrovascular, coronary and lung cancer incidence). METHODS: We applied five approaches in a multivariable Cox model to account for the first level of clustering corresponding to cohort specification: (1) not accounting for the cohort or using (2) indicator variables, (3) strata, (4) a frailty term in frailty Cox models, (5) a random intercept under a mixed Cox, for cohort identification. We accounted for the second level of clustering due to common characteristics in the residential area by (1) a random intercept per small area or (2) applying variance correction. We assessed the stratified, frailty and mixed Cox approach through simulations under different scenarios for heterogeneity in the underlying hazards and the air pollution effects. RESULTS: Effect estimates were stable under approaches used to adjust for cohort but substantially differed when no adjustment was applied. Further adjustment for the small area grouping increased the effect estimates' standard errors. Simulations confirmed identical results between the stratified and frailty models. In ELAPSE we selected a stratified multivariable Cox model to account for between-cohort heterogeneity without adjustment for small area level, due to the small number of subjects and events in the latter. CONCLUSIONS: Our study supports the need to account for between-cohort heterogeneity in multi-center collaborations using pooled individual level data.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Environmental Exposures and Health Systems Research > Physical Hazards and Health (Röösli)
UniBasel Contributors:de Hoogh, Kees and Vienneau, Danielle
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:0160-4120
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Related URLs:
Identification Number:
edoc DOI:
Last Modified:21 Dec 2022 09:56
Deposited On:21 Dec 2022 09:56

Repository Staff Only: item control page