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      Modeling geostatistical incomplete spatially correlated survival data with applications to COVID-19 mortality in Ghana

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          Abstract

          Survival models which incorporate frailties are common in time-to-event data collected over distinct spatial regions. While incomplete data are unavoidable and a common complication in statistical analysis of spatial survival research, most researchers still ignore the missing data problem. In this paper, we propose a geostatistical modeling approach for incomplete spatially correlated survival data. We achieve this by exploring missingness in outcome, covariates, and spatial locations. In the process, we analyze incomplete spatially referenced survival data using a Weibull model for the baseline hazard function and correlated log-Gaussian frailties to model spatial correlation. We illustrate the proposed method with simulated data and an application to geo-referenced COVID-19 data from Ghana. There are several disagreements between parameter estimates and credible intervals widths obtained using our proposed approach and complete case analysis. Based on these findings, we argue that our approach provides more reliable parameter estimates and have higher predictive accuracy.

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          Most cited references66

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          Is Open Access

          OpenSAFELY: factors associated with COVID-19 death in 17 million patients

          COVID-19 has rapidly impacted on mortality worldwide. 1 There is unprecedented urgency to understand who is most at risk of severe outcomes, requiring new approaches for timely analysis of large datasets. Working on behalf of NHS England we created OpenSAFELY: a secure health analytics platform covering 40% of all patients in England, holding patient data within the existing data centre of a major primary care electronic health records vendor. Primary care records of 17,278,392 adults were pseudonymously linked to 10,926 COVID-19 related deaths. COVID-19 related death was associated with: being male (hazard ratio 1.59, 95%CI 1.53-1.65); older age and deprivation (both with a strong gradient); diabetes; severe asthma; and various other medical conditions. Compared to people with white ethnicity, black and South Asian people were at higher risk even after adjustment for other factors (HR 1.48, 1.29-1.69 and 1.45, 1.32-1.58 respectively). We have quantified a range of clinical risk factors for COVID-19 related death in the largest cohort study conducted by any country to date. OpenSAFELY is rapidly adding further patients’ records; we will update and extend results regularly.
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            Missing data: our view of the state of the art.

            Statistical procedures for missing data have vastly improved, yet misconception and unsound practice still abound. The authors frame the missing-data problem, review methods, offer advice, and raise issues that remain unresolved. They clear up common misunderstandings regarding the missing at random (MAR) concept. They summarize the evidence against older procedures and, with few exceptions, discourage their use. They present, in both technical and practical language, 2 general approaches that come highly recommended: maximum likelihood (ML) and Bayesian multiple imputation (MI). Newer developments are discussed, including some for dealing with missing data that are not MAR. Although not yet in the mainstream, these procedures may eventually extend the ML and MI methods that currently represent the state of the art.
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              A Test of Missing Completely at Random for Multivariate Data with Missing Values

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                Author and article information

                Journal
                Spat Stat
                Spat Stat
                Spatial Statistics
                Elsevier B.V.
                2211-6753
                20 February 2023
                20 February 2023
                : 100730
                Affiliations
                [1]Department of Statistics, University of Connecticut, 215 Glenbrook Rd Unit 4120, Storrs, 06269-4120, CT, USA
                Author notes
                [* ]Corresponding author.
                Article
                S2211-6753(23)00005-2 100730
                10.1016/j.spasta.2023.100730
                9940474
                425ed8ad-ebf5-4fe5-a48f-1d158acf8ea8
                © 2023 Elsevier B.V. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 7 September 2022
                : 1 January 2023
                : 14 February 2023
                Categories
                Article

                bayesian modeling,covid-19,frailties,incomplete data,multiple imputation,spatial survival

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