标题： 生存结果中介分析的效应量度量比较及其在弗雷明汉心脏研究中的应用 显示英文标题

标题： Comparison of Effect Size Measures for Mediation Analysis of Survival Outcomes with Application to the Framingham Heart Study

摘要： 在生存结果的中介分析方面，研究趋势正在增加。 这些分析有助于研究人员更好地理解暴露如何通过中介变量影响疾病结果。 然而，由于生存结果中存在删失观测，将中介分析从线性模型扩展到生存结果并不直接。 在本文中，我们将基于线性回归中的$R^2$的中介效应大小度量扩展到生存结果。 由于生存模型中$R^2$有多种定义，我们比较和评估了五种$R^2$的中介度量。 根据广泛的模拟，我们推荐两种具有良好操作特性的$R^2$度量。 我们通过分析弗雷明汉心脏研究中环境暴露与冠心病发生时间和全因死亡率之间关系的多种生活方式风险因素的中介效应，说明了基于$R^2$的中介度量的实用性。 显示英文摘要

摘要： There is an increasing trend of research in mediation analysis for survival outcomes. Such analyses help researchers to better understand how exposure affects disease outcomes through mediators. However, due to censored observations in survival outcomes, it is not straightforward to extend mediation analysis from linear models to survival outcomes. In this article, we extend a mediation effect size measure based on $R^2$ in linear regression to survival outcomes. Due to multiple definitions of $R^2$ for survival models, we compare and evaluate five $R^2$ measures for mediation analysis. Based on extensive simulations, we recommend two $R^2$ measures with good operating characteristics. We illustrate the utility of the $R^2$-based mediation measures by analyzing the mediation effects of multiple lifestyle risk factors on the relationship between environmental exposures and time to coronary heart disease and all-cause mortality in the Framingham Heart Study.