ArticleAIDS research and human retroviruses2015
A Comparison of Seven Cox Regression-Based Models to Account for Heterogeneity Across Multiple HIV Treatment Cohorts in Latin America and the Caribbean.
Article in AIDS research and human retroviruses, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 18 citations in OpenAlex.
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- Statistical methods in the analysis of multicentre HIV randomized controlled trials in the African region: a scoping review.BMC medical research methodology · 2025Article
- RNA methylation influences TDP43 binding and disease pathogenesis in models of amyotrophic lateral sclerosis and frontotemporal dementia.Molecular cell · 2023Article
- Tuberculosis treatment intermittency in the continuation phase and mortality in HIV-positive persons receiving antiretroviral therapy.BMC infectious diseases · 2022Observational
- Vegetable intake and the risk of bladder cancer in the BLadder Cancer Epidemiology and Nutritional Determinants (BLEND) international study.BMC medicine · 2021Article
- Grain and dietary fiber intake and bladder cancer risk: a pooled analysis of prospective cohort studies.The American journal of clinical nutrition · 2020Article
- The impact of data quality and source data verification on epidemiologic inference: a practical application using HIV observational data.BMC public health · 2019Article
- HIV-related tuberculosis: mortality risk in persons without vs. with culture-confirmed disease.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2019Article
- Early Retention in Care Neither Mediates Nor Modifies the Effect of Sex and Sexual Mode of HIV Acquisition on HIV Survival in the Americas.AIDS patient care and STDs · 2018Article
- Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort.Journal of the International AIDS Society · 2018Article
- The effectiveness and cost-effectiveness of community-based support for adolescents receiving antiretroviral treatment: an operational research study in South Africa.Journal of the International AIDS Society · 2018Article
- Shifting the HIV Training and Research Paradigm to Address Disparities in HIV Outcomes.AIDS and behavior · 2016Article
- The occurrence of Simpson's paradox if site-level effect was ignored in the TREAT Asia HIV Observational Database.Journal of clinical epidemiology · 2016Article
- Incidence of virological failure and major regimen change of initial combination antiretroviral therapy in the Latin America and the Caribbean: an observational cohort study.The lancet. HIV · 2015Observational
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 5 countries.
Funding
Abstract
Many studies of HIV/AIDS aggregate data from multiple cohorts to improve power and generalizability. There are several analysis approaches to account for cross-cohort heterogeneity; we assessed how different approaches can impact results from an HIV/AIDS study investigating predictors of mortality. Using data from 13,658 HIV-infected patients starting antiretroviral therapy from seven Latin American and Caribbean cohorts, we illustrate the assumptions of seven readily implementable approaches to account for across cohort heterogeneity with Cox proportional hazards models, and we compare hazard ratio estimates across approaches. As a sensitivity analysis, we modify cohort membership to generate specific heterogeneity conditions. Hazard ratio estimates varied slightly between the seven analysis approaches, but differences were not clinically meaningful. Adjusted hazard ratio estimates for the association between AIDS at treatment initiation and death varied from 2.00 to 2.20 across approaches that accounted for heterogeneity; the adjusted hazard ratio was estimated as 1.73 in analyses that ignored across cohort heterogeneity. In sensitivity analyses with more extreme heterogeneity, we noted a slightly greater distinction between approaches. Despite substantial heterogeneity between cohorts, the impact of the specific approach to account for heterogeneity was minimal in our case study. Our results suggest that it is important to account for across cohort heterogeneity in analyses, but that the specific technique for addressing heterogeneity may be less important. Because of their flexibility in accounting for cohort heterogeneity, we prefer stratification or meta-analysis methods, but we encourage investigators to consider their specific study conditions and objectives.
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