本文選題：生存資料　切入點(diǎn)：中介分析　出處：《南京醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：隨著癌癥確診率的提高,越來越多的人關(guān)注癌癥的危險(xiǎn)因素及其預(yù)后的影響因素。雖然研究者們能找到不同癌癥預(yù)后的影響因素,但是這些影響因素如何作用于預(yù)后尚不清楚。中介分析作為一種能夠探索暴露與結(jié)局間因果作用機(jī)制的方法,廣受關(guān)注。目前,可用于癌癥預(yù)后研究的中介分析方法共有五種,分別是VanderWeele法、Baron-Kenny法、Imai法、Sobel法和Inverse Weight法(IW法)。本研究的目的就是對(duì)這五種方法進(jìn)行評(píng)價(jià),為實(shí)際應(yīng)用時(shí)方法的選擇提供依據(jù)。本研究基于模擬試驗(yàn),產(chǎn)生不同參數(shù)設(shè)置下的模擬數(shù)據(jù)進(jìn)行模擬,分別比較這五種方法的第一類錯(cuò)誤、檢驗(yàn)效能、準(zhǔn)確度、精確度和分析效率。模擬試驗(yàn)結(jié)果顯示,當(dāng)暴露(X)與中介因素(M)不存在交互作用的情況下,IW法較其它方法檢驗(yàn)效能、估計(jì)準(zhǔn)確度和精度均低于其他幾種方法,Baron-Kenny法和Imai法的分析效率遠(yuǎn)低于VanderWeele法和Sobel法。Baron-Kenny法和Sobel法雖然模型簡(jiǎn)單、原理便于理解,但這兩種方法存在一定的局限性——不能處理暴露與中介因素存在交互作用以及暴露每變化一個(gè)水平對(duì)結(jié)局的效應(yīng)大小不相同的情況,而VanderWeele法則能較好地處理這些問題,故應(yīng)用范圍更廣。IW法對(duì)間接效應(yīng)的點(diǎn)估計(jì)是通過總效應(yīng)減去直接效應(yīng)間接得到的,同樣不適用于"暴露與中介因素存在交互作用"的情況。故當(dāng)"暴露與中介因素存在交互作用"的情況下,優(yōu)先考慮VanderWeele法和Imai法。當(dāng)暴露(X)與中介因素(M)存在交互作用的情況下,VanderWeele法和Imai法的檢驗(yàn)效能均隨著樣本量、總效應(yīng)、中介比的增大而增大,隨著刪失比的增大而減小;隨著暴露(X)與中介因素(M)之間相關(guān)系數(shù)的增大而先增大后減小。VanderWeele法的檢驗(yàn)效能受中介交互作用比(X:M,%)的影響較小,而Imai法則隨著(X:M,%)增大而逐漸減小。無論在何種參數(shù)情況下,VanderWeele法的檢驗(yàn)效能都不低于Imai法。且VanderWeele法的估計(jì)準(zhǔn)確度受樣本量、總效應(yīng)、相關(guān)系數(shù)、中介交互作用CX:M,%)、中介比(M%)和刪失比(cen%)的影響很小,其估計(jì)精度也遠(yuǎn)高于IW法。加上VanderWeele法可以得到間接效應(yīng)、直接效應(yīng)和總效應(yīng)的估計(jì)值,分析效率也高,故當(dāng)X和M存在交互作用的時(shí)候,VanderWeele法是首先推薦的一個(gè)方法。結(jié)論:對(duì)于生存資料,不論暴露(X)與中介因素(M)之間是否存在交互作用,不管從第一類錯(cuò)誤的控制、檢驗(yàn)效能、精確度、準(zhǔn)確度或者檢驗(yàn)效率考慮,VanderWeele法相較于IW法、Imai法、Baron-Kenny法和Sobel法都更為突出,是一個(gè)值得推薦的方法。
[Abstract]:With the rate of cancer diagnosis increasing, more and more people are concerned about the risk factors of cancer and its prognostic factors, although researchers can find the factors that affect the prognosis of different cancers. However, it is not clear how these factors affect the prognosis. As a method to explore the causal mechanism between exposure and outcome, mediation analysis has attracted much attention. At present, there are five kinds of intermediary analysis methods that can be used to study the prognosis of cancer. VanderWeele method is Baron-Kenny method and Inverse Weight method is IW method. The purpose of this study is to evaluate these five methods and to provide a basis for the selection of methods in practical application. Simulation data are generated under different parameter settings, and the first type errors of the five methods are compared, respectively. Test effectiveness, accuracy, accuracy and efficiency of analysis are compared. When there is no interaction between exposure X) and mediating factor M), the effectiveness of IW method is higher than that of other methods. The analytical efficiency of Baron-Kenny method and Imai method is much lower than that of VanderWeele method, Sobel method. Baron-Kenny method and Sobel method although the model is simple and the principle is easy to understand. But these two methods have some limitations-they can't deal with the interaction between exposure and mediating factors, and the difference in the effect of each level of exposure on the outcome, and the VanderWeele rule can better deal with these problems. So the point estimation of indirect effect is obtained by subtracting direct effect from total effect. The same does not apply in the case of "interaction between exposure and mediating factors". Therefore, in the case of "interaction between exposure and intermediary factors", Priority is given to VanderWeele method and Imai method. When there is interaction between X) and the intermediate factor M), the efficiency of van der Weele method and Imai method both increase with the increase of sample size, total effect and intermediary ratio, and decrease with the increase of censored ratio. With the increase of the correlation coefficient between the exposure X) and the intermediate factor M), the test effectiveness of the Vander Weele method increased first and then decreased. The test effectiveness of the Vander Weele method was less affected by the medium interaction than by X: M). However, the Imai rule decreases with the increase of X: M). The efficiency of Vander Weele method is not lower than that of Imai method under any parameters. The accuracy of VanderWeele method is estimated by sample size, total effect and correlation coefficient. The influence of the intermediary interaction, CX: M) and the cenb, is very small, and its estimation accuracy is much higher than that of the IW method. In addition, the VanderWeele method can obtain the estimated value of indirect effect, direct effect and total effect, and the efficiency of analysis is also high. Therefore, when there is interaction between X and M, Vander Weele method is the first recommended method. Conclusion: for survival data, whether or not there is interaction between X) and mediating factor M), whether or not there is interaction between X and M, no matter from the control of the first error, the effectiveness is tested. The Vander Weele method is more prominent than the IW method in comparison with the Baron-Kenny method and the Sobel method. It is a recommended method.
【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R73-31

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本文編號(hào)：1577390