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Accounting for leadtime in cohort studies: evaluating when to initiate HIV therapies by Stephen R. Cole; Rui Li; Kathryn Anastos; Roger Detels; Mary Young; Joan S. Chmiel; Alvaro Muñoz is a Mathematics article available to read on EtoBox.

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## Abstract Commonly reported comparisons of differences in disease progression according to disease staging at therapy initiation may be subject to bias if they do not account for the time it took the deferred group to reach the latter stage (that is, leadtime) and for previous events in those who initiate therapy at late stage (that is, unseen fast progressors). To estimate the impact of deferring initiation of highly active antiretroviral therapies (HAART) on time to clinical AIDS in the context of data from observational cohort studies, we describe a method that capitalizes on data from a pre‐HAART period to multiply impute estimated leadtimes and the unseen events among fast progressors. After accounting for leadtime and the unseen events, data from two large cohort studies (__N__=739) indicate that deferring HAART initiation until CD4 is below 200 cells/mm^3^ was detrimental compared to initiating between 201 and 350 (hazard ratio=1.97; 95 percent confidence interval [CI] 1.09, 3.54), and that failure to account for leadtime resulted in a 38 per cent higher hazard ratio. In contrast, initiating HAART between 201 and 350 did not increase the hazard of AIDS compared to initiati

Who reads Accounting for leadtime in cohort studies: evaluating when to initiate HIV therapies?

Author

Stephen R. Cole; Rui Li; Kathryn Anastos; Roger Detels; Mary Young; Joan S. Chmiel; Alvaro Muñoz

Publisher

John Wiley and Sons; Wiley (John Wiley & Sons); John Wiley & Sons Inc.; Wiley (ISSN 0277-6715)

Published

2004

Language

EN

Field

Mathematics (Physical Sciences)