Estimating time to event characteristics via longitudinal threshold regression models - an application to cervical dilation progression.

Publication Type
Journal Article
Year of Publication
Mulatya, Caroline M; McLain, Alexander C; Cai, Bo; Hardin, James W; Albert, Paul S
Stat Med
Date Published
2016 10 30
Female; Humans; Labor Stage, First; Longitudinal Studies; Pregnancy; Statistics as Topic; Time Factors

In longitudinal studies, it is sometimes of interest to estimate the distribution of the time a longitudinal process takes to traverse from one threshold to another. For example, the distribution of the time it takes a woman's cervical dilation to progress from 3 to 4 cm can aid the decision-making of obstetricians as to whether a stalled labor should be allowed to proceed or stopped in favor of other options. Often researchers treat this type of data structure as interval censored and employ traditional survival analysis methods. However, the traditional interval censoring approaches are inefficient in that they do not use all of the available data. In this paper, we propose utilizing a longitudinal threshold model to estimate the distribution of the elapsed time between two thresholds of the longitudinal process from repeated measurements. We extend this modeling framework to be used with multiple thresholds. A Wiener process under the first hitting time framework is used to represent survival distribution. We demonstrate our model through simulation studies and an analysis of data from the Consortium on Safe Labor study. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.