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Biomedical subjects

M Gail

Publications and source records attributed to M Gail.

7 recordsLinked to original sources

Selecting an efficient design for assessing exposure-disease relationships in an assembled cohort.

We develop approximate methods to compare the efficiencies and to compute the power of alternative potential designs for sampling from a cohort before beginning to collect exposure data. Our methods require only that the cohort be assembled, meaning that the numbers of individuals Nkj at risk at pairs of event times tk and tj greater than or equal to tk are available. To compute Nkj, one needs to know the entry, follow-up, censoring, and event history, but not the exposure, for each individual. Our methods apply to any "unbiased control sampling design," in which cases are compared to a random sample of noncases at risk at the time of an event. We apply our methods to approximate the efficiencies of the nested case-control design, the case-cohort design, and an augmented case-cohort design, compared to the full cohort design, in an assembled cohort of 17,633 members of an insurance cooperative who were followed for mortality from prostatic cancer. The assumptions underlying the approximation are that exposure is unrelated both to the hazard of an event and to the hazard for censoring. The approximations performed well in simulations when both assumptions held and when the exposure was moderately related to censoring.

Biometry

Transmission of HTLV-I and HIV among homosexual men in Trinidad.

Risk for human T-cell lymphotropic virus type (HTLV-I) and human immunodeficiency virus (HIV) infection was evaluated in 100 homosexual or bisexual men from Trinidad. High seropositivity for HTLV-I (15% vs 2.4% in the general population) was linked to duration of homosexuality and numbers of partners, suggesting that HTLV-I, like HIV, can be transmitted by homosexual sex. Forty percent of homosexuals compared with 0.19% of the general population were seropositive for HIV, and sexual contact with US homosexual men and prior history of gonorrhea were major risk factors. The seroprevalence of HIV was three times higher than that for HTLV-I, suggesting that HIV is more efficiently transmitted, especially since HIV appears to have been recently introduced into Trinidad. Altered immune status was prominent in individuals infected with HIV and coinfected with HIV and HTLV-I. Whether HIV/HTLV-I coinfection amplifies clinical effects is a hypothesis that will require further evaluation.

Acquired Immunodeficiency Syndrome

Melanoma skin test antigens of improved sensitivity prepared from vesicular stomatitis virus-infected tumor cells.

Crude membrane (CM) extracts from three different cultured human melanoma lines that were "virus-augmented" (infected with vesicular stomatitis virus (VSV) and subsequently inactivated by ultraviolet light) produced positive skin tests in 17 of 20 (85%), 11 of 20 (55%), and 13 of 18 (72%) tests, respectively, performed in 20 melanoma patients. Identical CM extracts from the same melanoma lines that had not been infected with VSV gave positive skin tests in 2 of 20 (10%), 4 of 20 (20%), and 2 of 18 (11%) tests, respectively, performed in the 20 melanoma patients, and no positive tests in the control patients. The 3 virus-augmented extracts were positive in only 2 of 18 (11%), 0 of 18 (0%), and 1 of 17 (6%) control subjects, respectively. The controls consisted of six normal volunteers and 12 patients with cancers other than melanoma. The "virus-augmented" CM extracts thus exhibited markedly greater sensitivity without significant loss of specificity as compared to nonvirus augmented extracts when used as tumor-specific melaonma skin test antigens.

Adult

How many controls?

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Clinical Trials as Topic

A review and critique of some models used in competing risk analysis.

We have introduced a notation which allows one to define competing risk models easily and to examine underlying assumptions. We have treated the actuarial model for competing risk in detail, comparing it with other models and giving useful variance formulae both for the case when times of death are available and for the case when they are not. The generality of these methods is illustrated by an example treating two dependent competing risks.

Analysis of Variance