Statistical modelling for recurrent events: an application to sports injuries

Ullah, Shahid and Gabbett, Tim J. and Finch, Caroline F. (2014) Statistical modelling for recurrent events: an application to sports injuries. British Journal of Sports Medicine, 48 (17). pp. 1287-1293.

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Abstract

Background: Injuries are often recurrent, with subsequent injuries influenced by previous occurrences and hence correlation between events needs to be taken into account when analysing such data. Objective This paper compares five different survival models (Cox proportional hazards (CoxPH) model and the following generalisations to recurrent event data: Andersen-Gill (A-G), frailty, Wei-Lin-Weissfeld total time (WLW-TT) marginal, Prentice-Williams-Peterson gap time (PWP-GT) conditional models) for the analysis of recurrent injury data. Methods: Empirical evaluation and comparison of different models were performed using model selection criteria and goodness-of-fit statistics. Simulation studies assessed the size and power of each model fit. Results: The modelling approach is demonstrated through direct application to Australian National Rugby League recurrent injury data collected over the 2008 playing season. Of the 35 players analysed, 14 (40%) players had more than 1 injury and 47 contact injuries were sustained over 29 matches. The CoxPH model provided the poorest fit to the recurrent sports injury data. The fit was improved with the A-G and frailty models, compared to WLW-TT and PWP-GT models. Conclusions: Despite little difference in model fit between the A-G and frailty models, in the interest of fewer statistical assumptions it is recommended that, where relevant, future studies involving modelling of recurrent sports injury data use the frailty model inpreference to the CoxPH model or its other generalisations. The paper provides a rationale for future statistical modelling approaches for recurrent sports injury.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Published version made available under open access.
Faculty / Department / School: No Faculty
Date Deposited: 01 Jun 2017 03:20
Last Modified: 04 Jul 2017 05:38
Uncontrolled Keywords: athletic injuries; Australia; contusions; football; hematoma; humans; Kaplan-Meier estimate; musculoskeletal system; recurrence; risk factors; sprains and strains
Fields of Research : 11 Medical and Health Sciences > 1106 Human Movement and Sports Science > 110699 Human Movement and Sports Science not elsewhere classified
Socio-Economic Objective: C Society > 92 Health > 9299 Other Health > 929999 Health not elsewhere classified
Identification Number or DOI: 10.1136/bjsports-2011-090803
URI: http://eprints.usq.edu.au/id/eprint/32314

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