ArticleStatistics in medicine2019
Multiple mediation analysis with survival outcomes: With an application to explore racial disparity in breast cancer survival.
Article in Statistics in medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers.
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Who cites it
59 citing papers in PubMed.
- Causal decomposition framework for quantifying intervenable cancer health disparities.Biometrics · 2026Article
- Cancer Screening and Citizenship Status in the US.JAMA network open · 2026Article
- Effects of Sex on Mortality in Patients With Lung Cancer: A Multiple Mediation Analysis of The Boston Lung Cancer Study.Clinical lung cancer · 2026Article
- The Mediating Effect of Socioeconomic Status and Persistent Poverty on Racial and Ethnic Disparities in Pediatric Cancer Mortality in the United States.Cancer medicine · 2026Article
- Sex-specific association between osteoporosis and cataracts: UK Biobank and Hong Kong Osteoporosis Study.Archives of osteoporosis · 2026Article
- Social determinants of health, life's essential 8 metrics, and cardiovascular morbidity and mortality: a nationwide cohort study.American journal of preventive cardiology · 2026Article
- Psychosocial determinants of oral health-related quality of life in periodontitis patients.Scientific reports · 2025Article
- Cardiovascular disease-specific and all-cause mortality across socioeconomic status and lifestyles among patients with established cardiovascular disease in communities of China: data from a national population-based cohort.Heart (British Cardiac Society) · 2025Observational
- Socioeconomic Disadvantage, All-Cause and Cause-Specific Mortality in Patients Treated With Maintenance Dialysis: A Mediation Analysis of Geographical Inequity and Multimorbidity.Kidney medicine · 2025Article
- Mediation Analysis to Investigate Differences in Prostate Cancer Diagnosis Stage Through Environmental Risk Factors in Louisiana.Current oncology (Toronto, Ont.) · 2025Article
- Mediating Effect of Established Risk Factors on Association Between Social Determinants and Cardiovascular Disease Mortality.JACC. Advances · 2025Article
- Article
- The Association of Apathy With Incident Dementia: A Multiple Mediation Analysis of Cardiovascular Risk Factors.International journal of geriatric psychiatry · 2025Article
- Residential greenness and chronic obstructive pulmonary disease in a large cohort in southern China: Potential causal links, risk trajectories, and mediation pathways.Journal of advanced research · 2025Article
- Mediation of Ethnic Disparity in the 5-Year Mortality of Cervical Cancer Patients in the US, 2001-2019.Healthcare (Basel, Switzerland) · 2025Article
- Comparison of Associations of Food Security Instruments and Mediators With Premature All-Cause and Cardiovascular Disease Death in US Adults.Circulation. Cardiovascular quality and outcomes · 2025Article
- Asthma and cognitive dysfunction in older adults: the mediating role of systemic immune-inflammation index.Scientific reports · 2024Article
- Genomic and Socioeconomic Determinants of Racial Disparities in Breast Cancer Survival: Insights from the All of Us Program.Cancers · 2024Article
- Mediators of racial and ethnic inequities in clinical trial participation among patients with cancer, 2011-2023.JNCI cancer spectrum · 2024Article
- Association between social determinants of health and survival among the US cancer survivors population.BMC medicine · 2024Article
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Authors and funding
4 authors.
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Abstract
Mediation analysis allows the examination of effects of a third variable in the pathway between an exposure and an outcome. The general multiple mediation analysis method, proposed by Yu et al, improves traditional methods (eg, estimation of natural and controlled direct effects) to enable consideration of multiple mediators/confounders simultaneously and the use of linear and nonlinear predictive models for estimating mediation/confounding effects. In this paper, we extend the method for time-to-event outcomes and apply the method to explore the racial disparity in breast cancer survivals. Breast cancer is the most common cancer and the second leading cause of cancer death among women of all races. Despite improvement of survival rates of breast cancer in the US, a significant difference between white and black women remains. Previous studies have found that more advanced and aggressive tumors and less than optimal treatment may explain the lower survival rates for black women as compared to white women. Due to limitations of current analytic methods and the lack of comprehensive data sets, researchers have not been able to differentiate the relative effect each factor contributes to the overall racial disparity. We use the CDC-funded Patterns of Care study to examine the determinants of racial disparities in breast cancer survival using a novel multiple mediation analysis. Using the proposed method, we applied the Cox hazard model and multiple additive regression trees as predictive models and found that all racial disparity in survival among Louisiana breast cancer patients were explained by factors included in the study.
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