Seppä, K, Rue, H, Hakulinen, T, Läärä, E, Sillanpää, MJ, Pitkäniemi, J. Estimating multilevel regional variation in excess mortality of cancer patients using integrated nested Laplace approximation. Statistics in Medicine. 2019; 38: 778– 791. https://doi.org/10.1002/sim.8010
Estimating multilevel regional variation in excess mortality of cancer patients using integrated nested Laplace approximation
|Author:||Seppä, Karri1; Rue, Håvard2; Hakulinen, Timo1;|
1Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
2Department of Mathematical Sciences, Norwegian University of Science and Technology, Trondheim, Norway
3Research Unit of Mathematical Sciences, University of Oulu, Oulu, Finland
4Biocenter Oulu, Oulu, Finland
5Department of Public Health, University of Helsinki, Helsinki, Finland
|Online Access:||PDF Full Text (PDF, 0.4 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2019052216654
John Wiley & Sons,
|Publish Date:|| 2019-10-17
Models of excess mortality with random effects were used to estimate regional variation in relative or net survival of cancer patients. Statistical inference for these models based on the Markov chain Monte Carlo (MCMC) methods is computationally intensive and, therefore, not feasible for routine analyses of cancer register data. This study assessed the performance of the integrated nested Laplace approximation (INLA) in monitoring regional variation in cancer survival. Poisson regression model of excess mortality including both spatially correlated and unstructured random effects was fitted to the data of patients diagnosed with ovarian and breast cancer in Finland during 1955–2014 with follow up from 1960 through 2014 by using the period approach with five‐year calendar time windows. We estimated standard deviations associated with variation (i) between hospital districts and (ii) between municipalities within hospital districts. Posterior estimates based on the INLA approach were compared to those based on the MCMC simulation. The estimates of the variation parameters were similar between the two approaches. Variation within hospital districts dominated in the total variation between municipalities. In 2000–2014, the proportion of the average variation within hospital districts was 68% (95% posterior interval: 35–93%) and 82% (60–98%) out of the total variation in ovarian and breast cancer, respectively. In the estimation of regional variation, the INLA approach was accurate, fast, and easy to implement by using the R‐INLA package.
Statistics in medicine
|Pages:||778 - 791|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
112 Statistics and probability
Karri Seppä was supported by a grant from the Cancer Foundation Finland (to J. Pitkäniemi).
© 2018 John Wiley & Sons, Ltd. This is the peer reviewed version of the following article: Seppä, K, Rue, H, Hakulinen, T, Läärä, E, Sillanpää, MJ, Pitkäniemi, J. Estimating multilevel regional variation in excess mortality of cancer patients using integrated nested Laplace approximation. Statistics in Medicine. 2019; 38: 778– 791. https://doi.org/10.1002/sim.8010, which has been published in final form at https://doi.org/10.1002/sim.8010.
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