• Proceedings of the Korean Statistical Society Conference
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• 2002.11a
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• pp.197-201
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• 2002

The healthy worker effect is an important issue in occupational epidemiology. We proposed a new statistical method to test the relationship between exposure and time to death in the presence of the healthy worker effect. In this study, we considered the healthy worker hire effect to operate as a confounder and the healthy worker survival effect to operate as a confounder and an intermediate variable. The basic idea of the proposed method reflects the length bias-sampling caused by changing one's employment status. Simulation studies were also carried out to compare the proposed method with the Cox proportional hazards models. According to our simulation studies, both the proposed test and the test based on the Cox model having the change of the employment status as a time-dependent covariate seem to be satisfactory at an upper 5% significance level. The Cox models, however, are inadequate with the change, if any, of the employment status as time-independent covariate. The proposed test is superior in power to the test based on the Cox model including the time-dependent employment status.

• The Korean Journal of Applied Statistics
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• v.36 no.5
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• pp.415-445
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• 2023

Oftentimes, the time dependent treatment covariate and the time dependent confounders exist in observation studies. It is an important problem to correctly adjust for the time dependent confounders in the propensity score analysis. Recently, In the survival data, Hade et al. (2020) used a propensity score matching method to correctly estimate the treatment delay effect when the time dependent confounder affects time to the treatment time, where the treatment delay effects is defined to the delay in treatment reception. In this paper, we proposed the Cox model based marginal structural model (Cox-MSM) framework to estimate the treatment delay effect and conducted extensive simulation studies to compare our proposed Cox-MSM with the propensity score matching method proposed by Hade et al. (2020). Our simulation results showed that the Cox-MSM leads to more exact estimate for the treatment delay effect compared with two sequential matching schemes based on propensity scores. Example from study in treatment discontinuation in conjunction with simulated data illustrates the practical advantages of the proposed Cox-MSM.