Statistical modelling for recurrent events: an application to sports injuries

Ullah, Shahid, Gabbett, Tim J. and Finch, Caroline F. (2012) Statistical modelling for recurrent events: an application to sports injuries. British Journal of Sports Medicine, 48 17: 1287-1293. doi:10.1136/bjsports-2011-090803

Author Ullah, Shahid
Gabbett, Tim J.
Finch, Caroline F.
Title Statistical modelling for recurrent events: an application to sports injuries
Journal name British Journal of Sports Medicine   Check publisher's open access policy
ISSN 0306-3674
Publication date 2012
Sub-type Article (original research)
DOI 10.1136/bjsports-2011-090803
Volume 48
Issue 17
Start page 1287
End page 1293
Total pages 8
Place of publication London, United Kingdom
Publisher BMJ Group
Collection year 2013
Language eng
Formatted 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 in preference to the CoxPH model or its other generalisations. The paper provides a rationale for future statistical modelling approaches for recurrent sports injury.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published Online First 7 August 2012

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Human Movement and Nutrition Sciences Publications
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Created: Tue, 20 Nov 2012, 14:29:07 EST by Deborah Noon on behalf of School of Human Movement and Nutrition Sciences