|
| 1 | +--- |
| 2 | +title: "Getting started with clonecensorweighting" |
| 3 | +output: rmarkdown::html_vignette |
| 4 | +vignette: > |
| 5 | + %\VignetteIndexEntry{Getting started with clonecensorweighting} |
| 6 | + %\VignetteEngine{knitr::rmarkdown} |
| 7 | + %\VignetteEncoding{UTF-8} |
| 8 | +--- |
| 9 | + |
| 10 | +```{r, include = FALSE} |
| 11 | +knitr::opts_chunk$set( |
| 12 | + collapse = TRUE, |
| 13 | + comment = "#>" |
| 14 | +) |
| 15 | +``` |
| 16 | + |
| 17 | +```{r setup} |
| 18 | +library(clonecensorweighting) |
| 19 | +``` |
| 20 | + |
| 21 | +## Why clone-censor-weighting? |
| 22 | + |
| 23 | +Suppose we want to know whether surgery improves survival in lung cancer |
| 24 | +patients. Comparing patients who had surgery against those who did not, using a |
| 25 | +naive analysis, can be badly biased. One reason is *immortal time bias*: to |
| 26 | +appear in the "surgery" group, a patient has to survive long enough to actually |
| 27 | +receive surgery. That guaranteed survival time gets unfairly credited to the |
| 28 | +surgery group. |
| 29 | + |
| 30 | +Clone-censor-weighting (CCW) is a technique used in target trial emulation to |
| 31 | +address this. The idea has three parts, which also give the method its name: |
| 32 | + |
| 33 | +- **Clone**: each patient is copied into every treatment strategy under |
| 34 | + comparison, so that at the start of follow-up everyone is compatible with |
| 35 | + every strategy. |
| 36 | +- **Censor**: a clone is censored at the moment the patient's observed data |
| 37 | + stops being consistent with the strategy that clone was assigned to. |
| 38 | +- **Weight**: inverse-probability-of-censoring weights correct for the |
| 39 | + artificial censoring introduced in the previous step. |
| 40 | + |
| 41 | +This vignette walks through the pipeline end to end, using a lung cancer |
| 42 | +dataset that ships with the package. |
| 43 | + |
| 44 | +## The example data |
| 45 | + |
| 46 | +The package includes `lungcancer`, a dataset of 200 lung cancer patients. |
| 47 | + |
| 48 | +```{r} |
| 49 | +data(lungcancer) |
| 50 | +head(lungcancer) |
| 51 | +``` |
| 52 | + |
| 53 | +The columns we rely on are: |
| 54 | + |
| 55 | +- `id`: patient identifier |
| 56 | +- `surgery`: whether the patient received surgery (`1`) or not (`0`) |
| 57 | +- `timetosurgery`: time from baseline to surgery (`NA` if never operated on) |
| 58 | +- `death`: whether the patient died (`1`) or not (`0`) — the outcome event |
| 59 | +- `fup_obs`: observed follow-up time |
| 60 | + |
| 61 | +The remaining columns (`sex`, `charlson`, `perf`, `stage`, `emergency`, `age`, |
| 62 | +`deprivation`) describe patient characteristics that can be used as covariates |
| 63 | +when estimating censoring weights. |
| 64 | + |
| 65 | +We compare two strategies, and give them names we will reuse throughout: |
| 66 | + |
| 67 | +```{r} |
| 68 | +arms <- c("Control", "Surgery") |
| 69 | +``` |
| 70 | + |
| 71 | +The **grace period** is central to this analysis. It is the window during which |
| 72 | +a patient is still considered compatible with the "surgery" strategy. A patient |
| 73 | +who has surgery within the grace period is consistent with the treated strategy; |
| 74 | +one who does not is consistent with the control strategy. Here we use a grace |
| 75 | +period of 90 days. |
| 76 | + |
| 77 | +```{r} |
| 78 | +grace_period <- 90 |
| 79 | +``` |
| 80 | + |
| 81 | +## Step 1: Clone the data across arms |
| 82 | + |
| 83 | +`clone_arms()` copies the full dataset once per strategy and returns a list with |
| 84 | +one data frame per arm. |
| 85 | + |
| 86 | +```{r} |
| 87 | +clones <- clone_arms(lungcancer, arms) |
| 88 | +
|
| 89 | +names(clones) |
| 90 | +``` |
| 91 | + |
| 92 | +At this point the two data frames are identical copies of the original data. The |
| 93 | +strategy-specific logic is applied in the next steps. |
| 94 | + |
| 95 | +## Step 2: Build the policy and censoring logic |
| 96 | + |
| 97 | +Two helper functions describe how each arm's emulated outcome, follow-up, and |
| 98 | +censoring should be derived. They do not touch the data yet; they return the |
| 99 | +rules (as expressions) that will be applied in Step 3. |
| 100 | + |
| 101 | +`create_policy_A()` produces the emulated outcome and follow-up under the grace |
| 102 | +period policy. |
| 103 | + |
| 104 | +```{r} |
| 105 | +policy <- create_policy_A( |
| 106 | + arms = arms, |
| 107 | + treatment = "surgery", |
| 108 | + time_to_treatment = "timetosurgery", |
| 109 | + grace_period = grace_period, |
| 110 | + outcome = "death", |
| 111 | + followup = "fup_obs" |
| 112 | +) |
| 113 | +``` |
| 114 | + |
| 115 | +`create_censoring_logics_A()` produces the censoring indicator and the time at |
| 116 | +which that indicator can first be determined. |
| 117 | + |
| 118 | +```{r} |
| 119 | +censoring <- create_censoring_logics_A( |
| 120 | + arms = arms, |
| 121 | + treatment = "surgery", |
| 122 | + time_to_treatment = "timetosurgery", |
| 123 | + grace_period = grace_period, |
| 124 | + followup = "fup_obs" |
| 125 | +) |
| 126 | +``` |
| 127 | + |
| 128 | +Each of these returns a nested list, one entry per arm. The policy rules create |
| 129 | +the variables `.outcome` and `.fup`; the censoring rules create `.censoring` and |
| 130 | +`.fup_uncensored`. |
| 131 | + |
| 132 | +## Step 3: Apply the logic to the clones |
| 133 | + |
| 134 | +`apply_logics()` evaluates the rules against each arm's data. We combine the |
| 135 | +policy and censoring rules for each arm into a single set of new variables. |
| 136 | + |
| 137 | +```{r} |
| 138 | +logics <- list( |
| 139 | + Control = c(policy$Control, censoring$Control), |
| 140 | + Surgery = c(policy$Surgery, censoring$Surgery) |
| 141 | +) |
| 142 | +
|
| 143 | +emulated <- apply_logics(clones, logics) |
| 144 | +
|
| 145 | +lapply(emulated, names) |
| 146 | +``` |
| 147 | + |
| 148 | +Each arm's data frame now carries the emulated variables (`.outcome`, `.fup`, |
| 149 | +`.censoring`, `.fup_uncensored`) alongside the original columns. |
| 150 | + |
| 151 | +## Step 4: Assemble the final long-form data |
| 152 | + |
| 153 | +`create_final_data()` turns each patient into a sequence of time intervals |
| 154 | +(a counting-process, or "long", format). Internally it finds every event time, |
| 155 | +splits each patient's follow-up at those times, and combines the outcome and |
| 156 | +censoring information into one table per arm. |
| 157 | + |
| 158 | +```{r} |
| 159 | +final <- create_final_data( |
| 160 | + clones = emulated, |
| 161 | + clone_followup = ".fup", |
| 162 | + clone_outcome = ".outcome", |
| 163 | + clone_censoring = ".censoring", |
| 164 | + col_ids = "id" |
| 165 | +) |
| 166 | +
|
| 167 | +head(final$Surgery) |
| 168 | +``` |
| 169 | + |
| 170 | +Each row is now one patient-interval, bounded by `Tstart` and `Tstop`. Because a |
| 171 | +single patient contributes several intervals, each arm has many more rows than |
| 172 | +the original 200 patients: |
| 173 | + |
| 174 | +```{r} |
| 175 | +lapply(final, dim) |
| 176 | +``` |
| 177 | + |
| 178 | +This long-form data is the input for the final steps of a CCW analysis: |
| 179 | +estimating inverse-probability-of-censoring weights over time and fitting a |
| 180 | +weighted survival model to compare the two strategies. |
| 181 | + |
| 182 | +## Reading your own data |
| 183 | + |
| 184 | +The example above uses the bundled `lungcancer` data. To run the same workflow |
| 185 | +on your own data, it needs, at a minimum: |
| 186 | + |
| 187 | +- an **identifier** column for each patient |
| 188 | +- a binary **treatment** column, coded `0` / `1` |
| 189 | +- a **time-to-treatment** column (numeric, `NA` for the untreated) |
| 190 | +- a binary **outcome** column, coded `0` / `1` |
| 191 | +- a numeric **follow-up time** column |
| 192 | + |
| 193 | +The column *names* are up to you; you pass them to the arguments of the policy |
| 194 | +and censoring helpers, as we did above. Any additional columns are carried along |
| 195 | +and can serve as covariates. |
| 196 | + |
| 197 | +`read_trial_data()` is a small convenience wrapper for reading such data from a |
| 198 | +CSV file into a tibble. It does not impose any particular column structure; it |
| 199 | +simply reads the file: |
| 200 | + |
| 201 | +```{r, eval = FALSE} |
| 202 | +my_data <- read_trial_data("path/to/your-data.csv") |
| 203 | +``` |
| 204 | + |
| 205 | +## Summary |
| 206 | + |
| 207 | +In this vignette we: |
| 208 | + |
| 209 | +- motivated clone-censor-weighting with a lung cancer surgery question and the |
| 210 | + problem of immortal time bias, |
| 211 | +- cloned the data across a control and a surgery arm with `clone_arms()`, |
| 212 | +- described the grace-period policy and censoring rules with `create_policy_A()` |
| 213 | + and `create_censoring_logics_A()`, |
| 214 | +- applied those rules with `apply_logics()`, |
| 215 | +- and assembled a long-form analysis dataset with `create_final_data()`. |
| 216 | + |
| 217 | +The remaining steps of a full CCW analysis — estimating censoring weights and |
| 218 | +fitting a weighted outcome model — build directly on this long-form dataset. |
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