FULL LIKELIHOOD INFERENCES IN THE COX MODEL

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1 October 20, 2007 FULL LIKELIHOOD INFERENCES IN THE COX MODEL BY JIAN-JIAN REN 1 AND MAI ZHOU 2 University of Central Florida and University of Kentucky Abstract We use the empirical likelihood approach to parameterize the full likelihood function of the Cox model via baseline distribution F 0 instead of the usual baseline hazard parameterization. After explicitly profiling out nuisance parameter F 0, the profile likelihood function for regression parameter β 0 is obtained, and the maximum likelihood estimator MLE) for β 0, F 0 ) is derived. The relation between the MLE and Cox s partial likelihood estimator for β 0 is made clear by showing that Taylor s expansion gives Cox s partial likelihood estimating function as the leading term of the profile estimating function induced by the full likelihood function. We show that the log full-likelihood ratio has an asymptotic chi-squared distribution, while the simulation studies indicate that for small or moderate sample sizes, the MLE performs favorably over Cox s partial likelihood estimator. Moreover, we present a real dataset example, where our full-likelihood ratio test and Cox s partial likelihood ratio test lead to statistically different conclusions. 1 Introduction Since Cox 1972), the following Cox s regression model has become one of the most widely used tools in analyzing survival data: 1) λt; z) = λ 0 t) expz T β), where Z is a p -dimensional vector of covariates, β is the regression parameter, and λt; z) is the conditional hazard function of random variable r.v.) X given Z = z with λ 0 t) as an arbitrary baseline hazard function. Suppose that X 1, Z 1 ),, X n, Z n ) is a random sample of X, Z), and the actually observed censored survival data are 2) V 1, δ 1, Z 1 ), V 2, δ 2, Z 2 ),, V n, δ n, Z n ), where V i = min{x i, Y i }, δ i = I{X i Y i }, and Y i is the right censoring variable that has a distribution function d.f.) F Y and is independent of X i, Z i ) or independent of 1 Research supported in part by NSF grant DMS Research supported in part by NSF grant DMS AMS 2000 subject classifications. 62N02. Key words and phrases. Right censored data, empirical likelihood, maximum likelihood estimator, partial likelihood. 1

2 X i given Z = Z i. Then, letting β 0 be the true value of β in 1), Cox s partial likelihood estimator ˆβ c for β 0 is given by the solution of equations Tsiatis, 1981): n 3) ϕ n β) n 1 δ i Z i n j=1 I{V j V i }Z j expz T j β) n j=1 I{V j V i } expz T j β) ) = 0. In the past few decades, ˆβc has been considered as the standard estimate for β 0 in statistical literature. Efficiency properties of ˆβ c were discussed by Efron 1977) and Oakes 1977). In particular, Efron 1977) examined the complete likelihood function that is parameterized through baseline hazard function λ 0 t) in 1), and showed that Cox s partial likelihood function contains nearly all of the information about β 0, and ˆβ c is asymptotically efficient. Using the counting process approach, the books by Fleming and Harrington 1991), and Andersen, Borgan, Gill and Keiding 1993) give a complete treatment of asymptotic theory and include many relevant references. We also refer to Cox and Oakes 1984), Therneau and Grambsch 2000), Kalbfleisch and Prentice 2002) for discussions and references on developments of the Cox model. However, as pointed out in Cox and Oakes 1984; page 123), the efficiency results on ˆβ c are only asymptotic, and for finite samples the loss in precision from using the partial likelihood can be rather substantial. It is well known and confirmed clearly by our simulation results some of which are presented in Section 3) that the loss of efficiency can occur when, among other possible situations, the sample size is small or moderate, or β 0 is far from 0. It is also well known that in medical clinical trials, the sample size of survival data is often small or moderate. With these in mind, a natural question would be: Does the actual maximum likelihood estimator MLE) for β 0 i.e., the MLE based on the complete or full likelihood) perform better for small or moderate samples? We do not know the answer to this question because up to now the actual MLE has not been given in the literature. Using Poisson process arguments and parameterizing via baseline hazard λ 0 t), Efron 1977) showed that the complete or full likelihood function can be expressed as the product of Cox s partial likelihood function and a factor which involves both β and observed data; see equation 3.10) of Efron 1977). This means that for finite samples, the inference based on the partial likelihood is not based on all the observed data in the sense that the partial likelihood is not the likelihood of observed sample 2); see discussions on page 559 of Efron 1977). But, in Efron s formula it is not obvious how to profile out nuisance parameter λ 0 t) in order to obtain the actual MLE for β 0. In this article, we use the empirical likelihood approach Owen, 1988) to parameterize the full likelihood function of the Cox model 1) through F 0, which is the baseline d.f. 2

3 corresponding to baseline hazard function λ 0 t). After explicitly profiling out nuisance parameter F 0, the profile) likelihood function for β 0 is obtained and is not too much more complicated than the partial likelihood function; thus the actual MLE for β 0 can easily be computed. Note that the key to achieving our results here is the combination of utilizing the Lehmann family properties and our current understanding of the empirical likelihood techniques. Although Cox s partial likelihood has been carefully studied in the past 35 years, the Lehmann family properties, which are equivalent to the Cox model assumption 1), have not been used in the literature to parameterize the full likelihood function for the Cox model. Based on our full likelihood function for β 0, F 0 ) under the Cox model 1) with observed sample 2), Section 2 derives the MLE ˆβ n, ˆF n ) for β 0, F 0 ), where the relation between ˆβ n and ˆβ c is made clear by showing that Taylor s expansion gives Cox s partial likelihood estimating function ϕ n β) as the leading term of the profile estimating function ψ n β) induced by the full likelihood function. Section 2 also shows that the log full-likelihood ratio has an asymptotic chi-squared distribution. Section 3 discusses computational issues and treatment of ties, and presents some simulation results which show that the MLE ˆβ n performs favorably over ˆβ c for small or moderate sample sizes, especially when β 0 is away from 0. In Section 4, we discuss a real dataset example, where our full-likelihood ratio test and Cox s partial likelihood ratio test lead to statistically different conclusions. The findings in this article suggest that the MLE is preferred over Cox s partial likelihood estimator when sample size n is small or moderate. While this should not be a surprise since the MLE is based on all the observed data in the sense that it is based on the likelihood of observed sample 2), further studies can help better understand the estimation bias for finite samples which will be considered in a separate paper. Our other appealing findings here include: a) Wilk s theorem holds for the log fulllikelihood ratio of β 0 ; b) the full likelihood function leads to the MLE jointly for β 0, F 0 ); c) the computation for the MLE ˆβ n is only slightly more complicated than Cox s partial likelihood estimator ˆβ c ; d) our method can be extended to deal with other types of censored data. This last point is of particular interest because it is well known that the counting process approach is applicable to right censored data, but not complicated types of censored data, such as doubly censored data Chang and Yang, 1987; Gu and Zhang, 1993), interval censored data Groeneboom and Wellner, 1992), etc. While the main focus of this paper is the estimation of β 0 with small or moderate sample size n, it is worth noting that the MLE ˆF n for baseline distribution F 0 does not require any extension or approximation of the continuous proportional hazard model 3

4 to discrete data; rather it is based on a full likelihood function with possible candidate d.f. that assigns all its probability mass to observations V i s and interval V n), ). In contrast, there have been several competing methods for estimation of F 0 t) or the cumulative baseline hazard function Λ 0 t) that require the use of discrete logistic model Cox, 1972), or grouping continuous model Kalbfleisch and Prentice, 1973), or discretizing continuous proportional hazard model to have approximated MLE Breslow, 1974) in the context of counting process Andersen and Gill, 1982), etc.. For detailed discussions and more references, we refer to Andersen, Borgan, Gill and Keiding 1993; Section IV.1.5) and Kalbfleisch and Prentice 2002; page 143). 2 Maximum Likelihood Estimators For simplicity of presentation, in this section we consider the case when covariate Z is a scaler rather than a vector, i.e., p = 1 in 1). Since the generalization of our results to multivariate case is straightforward, the results for case with p > 1 are summarized at the end of this section. To parameterize the full likelihood function via F 0, we notice that under the assumption of the Cox model 1), each X i has a d.f. that satisfies 4) F t Zi ) = [ F 0 t)] c i ft Z i ) = c i f 0 t)[ F 0 t)] c i 1, where c i = expz i β), F 0 t) = [1 F 0 t)] and F t Z i ) is the conditional d.f. of X i given Z = Z i, while ft Z i ) and f 0 t) are the density functions of F t Z i ) and F 0 t), respectively. As the usual empirical likelihood treatment for continuous d.f. s, we let P {X = t Z = z} = df t z) = F t z) F t z), P {Y = t} = df Y t) = F Y t) F Y t ), df 0 t) = F 0 t) F 0 t ), and treat ft z) dt = df t z) and f 0 t) dt = df 0 t). Then, under the Cox model 1) with data 2), the likelihood function of V i, δ i ) given Z = Z i is given by P {V = V i, δ = δ i Z = Z i } = which under 4) is proportional to [F V i Z i ) F V i Z i )] δ i [ F V i Z i )] 1 δ i = FY V i ) df V i Z i )) δi df Y V i ) F V i Z i )) 1 δi, 4 c i [F 0 V i ) F 0 V i )]) δi F0 V i )) ci δ i.

5 Hence, if, without loss of generality, we assume that there are no ties among V i s and assume that V 1 < < V n with p i = F V i ) F V i ), the full likelihood function for β 0, F 0 ) in Cox model 1) with right censored data 2) is given by 5) Lβ, F ) = c i p i ) δ i n+1 j=i+1 p j )c i δ i, where F x) = n p i I{V i x} satisfying n+1 p i = 1 with 0 p n Denoting d i = c i + + c n, we show in the Appendix that for any fixed value β satisfying c n 1, likelihood function Lβ, F ) is maximized by: 6) 1 ˆF n t) = V i t d i δ i d i. In 5), we replace F by ˆF n, then from the proof of 6) given in the Appendix see A.1)), we obtain the following profile likelihood function for β 0 : 7) lβ) = ci d i ) δi di δ i d i ) di δ i. Thus, the MLE for β 0 is given by the solution ˆβ n which maximizes the value of lβ), and consequently ˆF n in 6) with β replaced by ˆβ n is the MLE for F 0. Differentiating log lβ), algebra shows that ˆβ n should be a solution of equation 8) ψ n β) n 1 n δ i Z i + e i log d i 1 ) = 0, d i where e i = Z i c i + + Z n c n, and due to 7), log 0 is set to 0 whenever it occurs. The Newton-Raphson method can be used to compute ˆβ n. Remark 1. On Condition c n 1: Throughout this section so far, all arguments require c n 1 for any fixed β, which ensures a well-defined 6) i.e., all terms on the right-hand side of equation are between 0 and 1) because d i > c n 1 for all 1 i < n. Note that the requirement of c n 1 for any positive or negative β is equivalent to requiring Z n = 0. Thus, in practice and for the rest of this paper, the natural way to handle this is to adjust Z i to Z i = Z i Z n, 1 i n, which rewrites model 1) as λt; Z i ) = λ β,n t) exp Z i β) with λ β,n t) = λ 0 t) expz n β). In 5)-8), we replace Z i and c i by Z i and c i = exp Z i β), respectively, then we have that c n 1 for any β; the solution of 8) gives the MLE for β 0, still denoted as ˆβ n ; and the resulting estimator in 5

6 6), still denoted by ˆFn, is the MLE for [ F 0 t)] eznβ, thus the MLE for F 0 t) is given by [ ˆFn t)] e Zn ˆβn. Our extensive simulation studies show that such a treatment on condition c n 1 gives excellent performance on the resulting MLE ˆβ n and the Newton-Raphson algorithm. Finally, it should be noted that adjusting Z i to Z i = Z i Z n, 1 i n, does not change the Cox s partial likelihood function, thus does not affect ˆβ c. Interestingly, by Taylor s expansion we show in the Appendix that the MLE ˆβ n is linked with Cox s partial likelihood estimator ˆβ c by the following: log n ) 9) ψ n β) = ϕ n β) + O p, n where ϕ n β) is the partial likelihood estimating function in 3). Further, Wilk s theorem on the log full-likelihood ratio is established below with proof given in the Appendix. THEOREM 1. Assume 9) and assume the regularity conditions on Cox model 1) Andersen and Gill, 1982). Then, R 0 = 2 log[lβ 0 )/l ˆβ n )] converges in distribution to a chi-squared distribution with 1 degree of freedom as n. Remark 2. On p -Dimensional Covariate Z i : If Z i and β are p -dimensional vectors with p > 1 in 1)-2), with minor modifications on the derivations and the proofs we have that 4)-9) hold with c i = expz i β) and e i as p -dimensional vectors, which imply that 8) has p equations. Moreover, a minor modified proof of Theorem 1 shows that R 0 converges in distribution to a chi-squared distribution with p degree of freedom. 3 Simulations This section first presents some simulation results to compare the MLE ˆβ n with Cox s partial likelihood estimator ˆβ c for the case without ties among V i s in 2). Then, we discuss how to handle ties among V i s, and present some simulation results to compare ˆβ n with Efron s estimator ˆβ E. In all our simulation studies, ˆβ n is calculated using the Newton-Raphson method with ˆβ c or ˆβ E as the initial value for the algorithm. Routines in FORTRAN for computing ˆβ n are available from the authors. Without Ties Among V i s in 2): Let Expµ) represent the exponential distribution with mean µ, and U0, 1) the uniform distribution on 0, 1). In our simulation studies, we consider F Y = Exp2) as the d.f. of the right censoring variable Y i, F Z = U0, 1) as the d.f. of Z, and F X Z = Expe Zβ 0 ) as the conditional d.f. of X given Z; thus X, Z) satisfies the Cox model 1) with regression parameter β 0 and baseline d.f. F 0 = Exp1). For each case of 6

7 β 0 = 1, 0, 1, we generate 1000 samples with sample size n = 15, 20, 30, 50, respectively, and for each n Table 1 includes the simulation average of ˆβ c and ˆβ n with the simulation standard deviation s.d.) given in the parenthesis next to them, respectively. The censoring percentage in each case is also reported in Table 1. Table 1. Comparison between ˆβ c and ˆβ n Parameter β 0 = 1 β 0 = 0 β 0 = 1 Sample Size Ave. ˆβc Ave. ˆβn Ave. ˆβc Ave. ˆβn Ave. ˆβc Ave. ˆβn n = ) ) ) ) ) ) n = ) ) ) ) ) ) n = ) ) ) ) ) ) n = ) ) ) ) ) ) Censoring % 23.7% 33.4% 45.4% Table 1 clearly shows that the MLE ˆβ n performs better than Cox s partial likelihood estimator ˆβ c for small or moderate sample sizes when β 0 is away from 0. For instance, the loss in precision for β 0 = ±1 with, say, n = 15 is reflected by the simulation Mean Square Error MSE). Simple calculation gives that when β 0 = 1, the simulation MSE is and for ˆβ c and ˆβ n, respectively, yielding 1.851/2.037 = 90.9% such ratio is 92.2% for n = 20), while when β 0 = 1, the simulation MSE is and for ˆβ c and ˆβ n, respectively, yielding 2.759/2.973 = 92.8% such ratio is 92.7% for n = 20). The loss in precision for ˆβ c shows even more obviously when we use β 0 = ±2, ±3, in simulation studies of Table 1. To illustrate, we include results for β 0 = 2 with sample size n = 15 in Table 2, where Relative Bias is ˆβ β 0 )/β 0, Relative MSE is E[ ˆβ β 0 )/β 0 ] 2 and the censoring variable is still Exp2). simulation relative MSE for ˆβ n and ˆβ c is 8.969/ = 26.6% in Table 2. Note that the ratio of Table 2. Comparison between ˆβc and ˆβ n β 0 = 2, n = 15, [Censoring Percentage] = 57.0% Estimator Simulation Mean s.d.) Simulation Relative Bias Simulation Relative MSE ˆβ c ) ˆβ n ) Finally, although not presented here, our simulation studies also show that according to Remark 1, the MLE ˆF n given in 6) provides a very good estimate for 1 [ F 0 t)] eznβ. 7

8 With Ties Among V i s in 2): Let W 1 < < W m be all the distinct observations of V 1 V n, where m < n, and for those tied V j s, the uncensored V j s are ranked ahead of the censored V j s. If we have, say, V 1 = V 2 = V 3 = W 1 with δ 1 = δ 2 = 1, δ 3 = 0, then by Efron s estimation see pages 48-49; Therneau and Grambsch, 2000) d i s in Cox s partial likelihood function are modified as d 1 = c 1 + c c n, d 2 = c 1 + c 2 )/2 + c c n, d 3 = c c n, etc., which give Efron s estimator ˆβ E. Applying these modified d i s in 7)-8), the MLE for β 0 when V i s have ties is given by the solution of 8), still denoted by ˆβ n. Some simulation results are presented in Tables 3-4 to compare the MLE ˆβ n with ˆβ E. In these simulation studies, we consider n = 15, F Y = Exp2), and F X Z = Expe Zβ 0 ), and we create ties among V i s as follows: compute t k = V 1 + k n V n V 1 ) for 0 k n+1, and set V i = t k+1 if V i [t k, t k+1 ), which represents rounding errors in practice that cause tied values among V i s. Table 3 includes the simulation results based on 1000 samples with F Z = U0, 1) for β 0 = 2 and β 0 = 2, respectively, and reports the average number m of distinct V i s. Table 4 includes results of the same simulation studies with F Z = Exp1) for β 0 = 0.75 and β 0 = 0.75, respectively. Table 3. Comparison between ˆβ E and ˆβ n F Z = U0, 1) Estimator Simul. Mean s.d.) Rel. Bias Rel. MSE Ave. m β 0 = 2 ˆβE ) Censoring: 57.0% ˆβn ) β 0 = 2 ˆβE ) Censoring: 16.8% ˆβn ) Table 4. Comparison between ˆβ E and ˆβ n F Z = Exp1) Estimator Simul. Mean s.d.) Rel. Bias Rel. MSE Ave. m β 0 = 0.75 ˆβE ) Censoring: 50.4% ˆβn ) β 0 = 0.75 ˆβE ) Censoring: 20.9% ˆβn ) Overall, Tables 3-4 show that the MLE ˆβ n performs favorably. In particular, note that the ratio of simulation relative MSE for ˆβ n and ˆβ E is 7.785/ = 37.59% for β 0 = 2 in Table 3, while such ratio is 4.701/ = 41.8% for β 0 = 0.75 in Table 4. 8

9 4 Data Example We consider the Stanford Heart Transplant data set Escobar and Meeker, 1992; it is available in R library with file name stanford2 ), where Z is the age of a patient and X is the survival time subject to right censoring. To see the smaller sample performance, we use observations number and observations number , respectively, to test H 0 : β = 0 vs. H 1 : β 0 using Wald test, the partial likelihood ratio PLR) test and our full likelihood ratio FLR) test according to Theorem 1. The results are summarized in Table 5, which show that PLR test and FLR test can lead to statistically different conclusions for smaller sample size n. Table 5. Stanford Heart Transplant Data n Censored Obs. ˆβc ˆβn Wald Test PLR Test FLR Test Obs. used: Obs. used: APPENDIX Proof of 6): Let a i = p i /b i and b i = n+1 j=i p j. Then, we have that b 1 = 1, b n+1 = p n + 1, b i+1 = b i p i ), 1 a i ) = b i+1 /b i, and algebra can rewrite 5) as A.1) Lβ, F ) = c i p i ) δ i b i p i ) c i δ i = c i a i ) δ i 1 a i ) d i δ i. From the 1st and 2nd partial derivatives of log L with respect to a i s, we know that the solution of equations log L)/ a i = 0 is given by â i = 1/d i, 1 i n, and it maximizes Lβ, F ) under condition c n 1. Hence, 6) follows from noting that ˆF n t) = V i t 1 â i) and that condition c n 1 implies all 0 â i 1. Proof of 9): We give the proof assuming that c n = 1 based on Remark 1), β M β < and Z has a finite support. From Taylor s expansion, we have in 8), A.2) ψ n β) = n 1 n 1 δ i Z i n 1 δ i e i + 1 ) d i 2ξi 2 + e n n log c n δ n c n = ϕ n β) + n 1 δ n Z n 1 2 R n = ϕ n β) + O p n 1 ) 1 2 R n, 9

10 where R n = n 1 δ ie i )/ξ 2 i with ξ i being between d i and d i δ i ), and we have A.3) R n 1 n e i d i 1) 2 = 1 n O p n 1 ) max Z i 1 i n e i d 2 i 1 1/d i) 2 1 n O p n 1 1 log n ) ) n i + 1 = O p n e i d ) 2 i c exp m i β)) expz i β m i β)) + + expz n β m i β)) for m i β) = min{z j β i j n}. The proof follows from A.2)-A.3). Proof of Theorem 1: Applying Taylor s expansion on log lβ 0 ) at point ˆβ n, we have that from ψ n β) = n 1 d dβ log lβ) in 8) and ψ n ˆβ n ) = 0, A.4) R 0 = nψ n ξ)β 0 ˆβ n ) 2 = ψ n ξ)[ n ˆβ n β 0 )] 2, where ξ is between ˆβ n and β 0. From 9), we know that n ˆβ n β 0 ) and n ˆβ c β 0 ) have the same limiting distribution N0, σ 2 ) for some constant 0 < σ 2 <. It suffices to show that ψ n ξ) converges to 1/σ2 in probability as n. From Taylor s expansion and c n = 1, we have that in 9) A.5) ψ n β) = e i log d i δ i d i + δ i e 2 ) i d i d i δ i ) { = n 1 e i δ i δ ) i d i 2ξi 2 + δ ie 2 i 1 + δ )} i d i d i ηi 2 = ϕ n β) R 1,n R 2,n, where R 1,n = n 1 δ ie i /ξ2 i and R 2,n = n 1 δ ie 2 i /d iη 2 i ) with ξ i and η i being between d i and d i δ i ). Applying the argument in A.3) to R 1,n and R 2,n, respectively, we obtain ψ n β) = ϕ n β) + O plog n)/n). The proof follows from the fact that ϕ n β) is the negative second derivative of the log of Cox s partial likelihood, and ϕ n β 0 ) converges to 1/σ 2 in probability as n ; see Andersen and Gill 1982). REFERENCES Andersen, P.K., Borgan, O., Gill, R.D., and Keiding, N.1993). Based on Counting Processes. Springer-Verlag, New York. Statistical Models 10

11 Andersen, P.K. and Gill, R.D. 1982). Cox s regression model for counting processes: a large sample study. Ann. Statist. 10, Breslow, N.E. 1974). Covariance analysis of censored survival data. Biometrics 30, Chang, M.N. and Yang, G.L. 1987). Strong consistency of a nonparametric estimator of the survival function with doubly censored data. Ann. Statist. 15, Cox, D.R. 1972). Regression models and life-tables with Discussion). J. R. Statist. Soc. B 34, Cox, D.R. and Oakes, D. 1984). Analysis of Survival Data. Chapman & Hall, London. Efron, B. 1977). The efficiency of Cox s likelihood function for censored data. J. Amer. Statist. Assoc. 72, Escobar, L.A. and Meeker, W.Q. 1992). Assessing influence in regression analysis with censored data. Biometrics 48, Fleming, T.R. and Harrington, D.P. 1991). Counting Processes and Survival Analysis. Wiley, New York. Groeneboom, P. and Wellner, J.A. 1992). Information Bounds and Nonparametric Maximum likelihood Estimation. Birkhäuser Verlag. Gu, M.G. and Zhang, C.H. 1993). Asymptotic properties of self-consistent estimators based on doubly censored data. Ann. Statist. 21, Kalbfleisch, J.D. and Prentice, R.L. 1973). Marginal likelihoods based on Cox s regression and life model. Biometrika 60, Kalbfleisch, J.D. and Prentice, R.L. 2002). The Statistical Analysis of Failure Time Data. John Wiley & Sons. Oakes, D. 1977). The asymptotic information in censored survival data. Biometrika 64, Owen, A.B. 1988). Empirical likelihood ratio confidence intervals for a single functional. Biometrika 75, Therneau, T.M. and Grambsch, P.M. 2000). Modeling Survival Data, Extending the Cox Model. Springer. Tsiatis, A.A. 1981). A large sample study of Cox s regression model. Ann. Statist. 9, DEPARTMENT OF MATHEMATICS DEPARTMENT OF STATISTICS UNIVERSITY OF CENTRAL FLORIDA UNIVERSITY OF KENTUCKY ORLANDO, FLORIDA LEXINGTON, KENTUCKY

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