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Mixed Effects with Cox model (multiple events)

2 messages · Maria Helena Mourino Silva Nunes, Ben Bolker

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Dear all,

I want to describe the time interval between mammography screenings as a function of several clinical and demographic variables. For each woman, I have several events and each event corresponds to the time interval between two consecutive mammography screenings. Also, women's data sets come from ten different primary health centres. I have data from 1995 up to 2013.

I was thinking on developing a Cox regression model with multiple events (as, for instance, Andersen and Gill model). Having in mind there are differences between the primary health centres, I was wondering if I could use a mixed model where women were nested on the primary health centres. I've already tried to use the "coxme" package but it didn't work. Is it possible to use a mixed model in this context? What package should I use?

Thanks, in advanced, for your attention.

Best regards,
Helena Mouri?o Nunes.
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On 14-03-11 11:26 AM, Maria Helena Mourino Silva Nunes wrote:
For CPH you will probably have to use a specialized package.  The
survival package has a frailty() function that "allows one to add a
simple random effects term to a Cox or survreg model" (and choose among
gamma, gaussian, or t-distributed random effects).  I don't know how
this will fit in with your multi-event model, but that's where I would
start ...

  Ben Bolker