Re: st: Many strata in Cox proportional hazard models

[David Svendsgaard <Svendsgaard.David@epamail.epa.gov>]

Did you check the  time-varying covariates box?
David J Svendsgaard, PhD
Biostatistician
EPA/ORD/NCEA/RTP, Mail Drop B-243-01
Research Triangle Park, NC 27711
Phone (919) 541-4186
Fax (919) 541-1818



From:	"Steve Rothenberg" <drlead@prodigy.net.mx>
To:	<statalist@hsphsun2.harvard.edu>
Date:	07/15/2011 01:56 PM
Subject:	st: Many strata in Cox proportional hazard models
Sent by:	owner-statalist@hsphsun2.harvard.edu



I'm trying to diagnose the proportional hazards assumption (and other
diagnostics) on Cox PH models.  I use a data set of mortality in  1154
subjects, with only baseline data measured at entry, and 185 failures
during
the ~8 year follow up.  The age range of the group at entry is 49 to 94
years and there are three ordered categories of exposure to the variable
of
interest.  All other independent variables in the model are dichotomous.

Since I expect baseline hazard to differ by age, I'm using age as the
stratification variable in stratified estimation.  A colleague has
suggested
I use monthly age strata.  I obtain 353 monthly strata each with from 1
to
10 subjects, an average N in each strata ~ 3.  I've tried an alternative
strata division of 5-year age periods, 9 stratum groups in all with from
5
to 282 subjects in each group, an average N in each strata ~ 125.

The models with the monthly age strata all return hazard ratios for the
exposure variable below 1, compared to the lowest, reference exposure
variable.  The models with the 5-year age strata all return hazard
ratios
for the exposure variables higher than 1.  Fit measures, such as AIC and
BIC
are far better in the monthly stratified model than in the 5-year
stratified
model.  The concordance index (Harrold's C) is .602 for the 5-year age
strata model and .615 in the monthly age strata model.

I've checked proportional hazards assumptions for the exposure variables
on
the each stratum of the 5-year strata model (along with other
diagnostics)
and get good compliance on 7 of the 9 strata.  I don't know where and
how to
begin checking the PH assumption on the monthly age strata model, due to
the
large number of strata and the fact that there are so many strata with
just
1 or 2 subjects.

I suspect overkill with monthly strata but wonder:

Question 1: Are there statistical drawbacks (other than diagnostic) to
using
so many strata for survival models, especially with many singleton
strata?

Question 2: Can anyone suggest available literature that discusses this
issue?

Steve Rothenberg
National Institute of Public Health
Cuernavaca, Morelos
Mexico

*
*   For searches and help try:
*   http://www.stata.com/help.cgi?search
*   http://www.stata.com/support/statalist/faq
*   http://www.ats.ucla.edu/stat/stata/


*
*   For searches and help try:
*   http://www.stata.com/help.cgi?search
*   http://www.stata.com/support/statalist/faq
*   http://www.ats.ucla.edu/stat/stata/