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American Journal of Epidemiology Vol. 145, No. 1: 72-80
Copyright © 1997 by The Johns Hopkins University School of Hygiene and Public Health


research-article

Time-to-Event Analysis of Longitudinal Follow-up of a Survey: Choice of the Time-scale

Edward L. Kom1,, Barry I. Graubard2 and Douglas Midthune3

1Biometric Research Branch, National Cancer Institute, Be-thesda, MD
2Biometry Branch, National Cancer Institute, Bethesda, MD
3Information Management Services, Silver Spring, MD

Reprint requests to Dr. Edward L Kom, Biometric Research Branch EPN-739, National Cancer Institute, Bethesda, MD 20892.

Following individuals sampled in a large-scale health survey for the development of diseases and/or death offers the opportunity to assess the prognostic significance of various risk factors. The proportional hazards regression model, which allows for the control of covariates, is frequently used for the analysis of such data. The authors discuss the appropriate time-scale for such regression models, and they recommend that age rather than time since the baseline survey (time-on-study) be used. Additionally, with age as the time-scale, control for calendar-period and/or birth cohort effects can be achieved by stratifying the model on birth cohort. Because, as discussed by the authors, many published analyses have used regression models with time-on-study as the time-scale, it is important to assess the magnitude of the error incurred from this type of incorrect modeling. The authors provide simple conditions for when incorrect use of time-on-study as the time-scale will nevertheless yield approximately unbiased proportional hazards regression coefficients. Examples are given using data from the first National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Followup Study. Additional issues concerning the analysis of longitudinal follow-up of survey data are briefly discussed. Am J Epidemiol 1997; 145: 72–80

cohort studies; epidemiologic methods; proportional hazards models; statistics; survey methods; survival analysis


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JAMAHome page
K. M. Flegal, B. I. Graubard, D. F. Williamson, and M. H. Gail
Excess Deaths Associated With Underweight, Overweight, and Obesity
JAMA, April 20, 2005; 293(15): 1861 - 1867.
[Abstract] [Full Text] [PDF]


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Cancer Epidemiol. Biomarkers Prev.Home page
M. Harvie, A. Howell, R. A. Vierkant, N. Kumar, J. R. Cerhan, L. E. Kelemen, A. R. Folsom, and T. A. Sellers
Association of Gain and Loss of Weight before and after Menopause with Risk of Postmenopausal Breast Cancer in the Iowa Women's Health Study
Cancer Epidemiol. Biomarkers Prev., March 1, 2005; 14(3): 656 - 661.
[Abstract] [Full Text] [PDF]


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BMJHome page
P Vineis, L Airoldi, F Veglia, L Olgiati, R Pastorelli, H Autrup, A Dunning, S Garte, E Gormally, P Hainaut, et al.
Environmental tobacco smoke and risk of respiratory cancer and chronic obstructive pulmonary disease in former smokers and never smokers in the EPIC prospective study
BMJ, February 5, 2005; 330(7486): 277.
[Abstract] [Full Text] [PDF]


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Am J EpidemiolHome page
L. E. Kelemen, L. H. Kushi, D. R. Jacobs Jr., and J. R. Cerhan
Associations of Dietary Protein with Disease and Mortality in a Prospective Study of Postmenopausal Women
Am. J. Epidemiol., February 1, 2005; 161(3): 239 - 249.
[Abstract] [Full Text] [PDF]


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Cancer Epidemiol. Biomarkers Prev.Home page
R. J. MacInnis, D. R. English, D. M. Gertig, J. L. Hopper, and G. G. Giles
Body Size and Composition and Risk of Postmenopausal Breast Cancer
Cancer Epidemiol. Biomarkers Prev., December 1, 2004; 13(12): 2117 - 2125.
[Abstract] [Full Text] [PDF]


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Cancer Epidemiol. Biomarkers Prev.Home page
J. R. Cerhan, J. D. Potter, J. M.E. Gilmore, C. A. Janney, L. H. Kushi, D. Lazovich, K. E. Anderson, T. A. Sellers, and A. R. Folsom
Adherence to the AICR Cancer Prevention Recommendations and Subsequent Morbidity and Mortality in the Iowa Women's Health Study Cohort
Cancer Epidemiol. Biomarkers Prev., July 1, 2004; 13(7): 1114 - 1120.
[Abstract] [Full Text] [PDF]


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Cancer Epidemiol. Biomarkers Prev.Home page
T. P. Erlinger, P. Muntner, and K. J. Helzlsouer
WBC Count and the Risk of Cancer Mortality in a National Sample of U.S. Adults: Results from the Second National Health and Nutrition Examination Survey Mortality Study
Cancer Epidemiol. Biomarkers Prev., June 1, 2004; 13(6): 1052 - 1056.
[Abstract] [Full Text] [PDF]


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Cancer Epidemiol. Biomarkers Prev.Home page
R. J. MacInnis, D. R. English, J. L. Hopper, A. M. Haydon, D. M. Gertig, and G. G. Giles
Body Size and Composition and Colon Cancer Risk in Men
Cancer Epidemiol. Biomarkers Prev., April 1, 2004; 13(4): 553 - 559.
[Abstract] [Full Text] [PDF]


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Cancer Epidemiol. Biomarkers Prev.Home page
M. Tseng, R. A. Breslow, R. F. DeVellis, and R. G. Ziegler
Dietary Patterns and Prostate Cancer Risk in the National Health and Nutrition Examination Survey Epidemiological Follow-up Study Cohort
Cancer Epidemiol. Biomarkers Prev., January 1, 2004; 13(1): 71 - 77.
[Abstract] [Full Text] [PDF]


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Cancer Epidemiol. Biomarkers Prev.Home page
R. J. MacInnis, D. R. English, D. M. Gertig, J. L. Hopper, and G. G. Giles
Body Size and Composition and Prostate Cancer Risk
Cancer Epidemiol. Biomarkers Prev., December 1, 2003; 12(12): 1417 - 1421.
[Abstract] [Full Text] [PDF]


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Cancer Epidemiol. Biomarkers Prev.Home page
D. M. Freedman, A. Sigurdson, M. M. Doody, K. Mabuchi, and M. S. Linet
Risk of Basal Cell Carcinoma in Relation to Alcohol Intake and Smoking
Cancer Epidemiol. Biomarkers Prev., December 1, 2003; 12(12): 1540 - 1543.
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Arch Intern MedHome page
L. A. Bazzano, J. He, L. G. Ogden, C. M. Loria, and P. K. Whelton
Dietary Fiber Intake and Reduced Risk of Coronary Heart Disease in US Men and Women: The National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study
Arch Intern Med, September 8, 2003; 163(16): 1897 - 1904.
[Abstract] [Full Text] [PDF]


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Eur Heart JHome page
R.M. Conroy, K. Pyorala, A.P. Fitzgerald, S. Sans, A. Menotti, G. De Backer, D. De Bacquer, P. Ducimetiere, P. Jousilahti, U. Keil, et al.
Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project
Eur. Heart J., June 1, 2003; 24(11): 987 - 1003.
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Eur Respir JHome page
S. Vandentorren, I. Baldi, I. Annesi Maesano, D. Charpin, F. Neukirch, L. Filleul, A. Cantagrel, and J.F. Tessier
Long-term mortality among adults with or without asthma in the PAARC study
Eur. Respir. J., March 1, 2003; 21(3): 462 - 467.
[Abstract] [Full Text] [PDF]


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JCOHome page
J.O. Ebbert, P. Yang, C.M. Vachon, R.A. Vierkant, J.R. Cerhan, A.R. Folsom, and T.A. Sellers
Lung Cancer Risk Reduction After Smoking Cessation: Observations From a Prospective Cohort of Women
J. Clin. Oncol., March 1, 2003; 21(5): 921 - 926.
[Abstract] [Full Text] [PDF]


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Am J EpidemiolHome page
I. Baldi, P. Lebailly, B. Mohammed-Brahim, L. Letenneur, J.-F. Dartigues, and P. Brochard
Neurodegenerative Diseases and Exposure to Pesticides in the Elderly
Am. J. Epidemiol., March 1, 2003; 157(5): 409 - 414.
[Abstract] [Full Text] [PDF]


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Am J EpidemiolHome page
P. Yang, J. R. Cerhan, R. A. Vierkant, J. E. Olson, C. M. Vachon, P. J. Limburg, A. S. Parker, K. E. Anderson, and T. A. Sellers
Adenocarcinoma of the Lung Is Strongly Associated with Cigarette Smoking: Further Evidence from a Prospective Study of Women
Am. J. Epidemiol., December 15, 2002; 156(12): 1114 - 1122.
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Ann Rheum DisHome page
T R Mikuls, K G Saag, L A Criswell, L A Merlino, R A Kaslow, B J Shelton, and J R Cerhan
Mortality risk associated with rheumatoid arthritis in a prospective cohort of older women: results from the Iowa Women's Health Study
Ann Rheum Dis, November 1, 2002; 61(11): 994 - 999.
[Abstract] [Full Text] [PDF]


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Cancer Epidemiol. Biomarkers Prev.Home page
T. A. Sellers, R. A. Vierkant, J. R. Cerhan, S. M. Gapstur, C. M. Vachon, J. E. Olson, V. S. Pankratz, L. H. Kushi, and A. R. Folsom
Interaction of Dietary Folate Intake, Alcohol, and Risk of Hormone Receptor-defined Breast Cancer in a Prospective Study of Postmenopausal Women
Cancer Epidemiol. Biomarkers Prev., October 1, 2002; 11(10): 1104 - 1107.
[Abstract] [Full Text] [PDF]


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Am J EpidemiolHome page
J. E. Olson, P. Yang, K. Schmitz, R. A. Vierkant, J. R. Cerhan, and T. A. Sellers
Differential Association of Body Mass Index and Fat Distribution with Three Major Histologic Types of Lung Cancer: Evidence from a Cohort of Older Women
Am. J. Epidemiol., October 1, 2002; 156(7): 606 - 615.
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Am J EpidemiolHome page
J. R. Cerhan, C. A. Janney, C. M. Vachon, T. M. Habermann, N. E. Kay, J. D. Potter, T. A. Sellers, and A. R. Folsom
Anthropometric Characteristics, Physical Activity, and Risk of Non-Hodgkin's Lymphoma Subtypes and B-Cell Chronic Lymphocytic Leukemia: A Prospective Study
Am. J. Epidemiol., September 15, 2002; 156(6): 527 - 535.
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Arch Intern MedHome page
J. He, L. G. Ogden, L. A. Bazzano, S. Vupputuri, C. Loria, and P. K. Whelton
Dietary Sodium Intake and Incidence of Congestive Heart Failure in Overweight US Men and Women: First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study
Arch Intern Med, July 22, 2002; 162(14): 1619 - 1624.
[Abstract] [Full Text] [PDF]


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Am. J. Clin. Nutr.Home page
L. A Bazzano, J. He, L. G Ogden, C. M Loria, S. Vupputuri, L. Myers, and P. K Whelton
Fruit and vegetable intake and risk of cardiovascular disease in US adults: the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study
Am. J. Clinical Nutrition, July 1, 2002; 76(1): 93 - 99.
[Abstract] [Full Text] [PDF]


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AJPHHome page
E. J. Samelson, Y. Zhang, D. P. Kiel, M. T. Hannan, and D. T. Felson
Effect of Birth Cohort on Risk of Hip Fracture: Age-Specific Incidence Rates in the Framingham Study
Am J Public Health, May 1, 2002; 92(5): 858 - 862.
[Abstract] [Full Text] [PDF]


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StrokeHome page
L. A. Bazzano, J. He, L. G. Ogden, C. Loria, S. Vupputuri, L. Myers, P. K. Whelton, and S. E. Kasner
Dietary Intake of Folate and Risk of Stroke in US Men and Women: NHANES I Epidemiologic Follow-Up Study * Editorial Comment: NHANES I Epidemiologic Follow-Up Study
Stroke, May 1, 2002; 33(5): 1183 - 1189.
[Abstract] [Full Text] [PDF]


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J. Am. Soc. Nephrol.Home page
P. Muntner, J. He, L. Hamm, C. Loria, and P. K. Whelton
Renal Insufficiency and Subsequent Death Resulting from Cardiovascular Disease in the United States
J. Am. Soc. Nephrol., March 1, 2002; 13(3): 745 - 753.
[Abstract] [Full Text] [PDF]



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