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Technological changes are impacting severely on the retail sector. In contrast to many other industries, recovery of the jobs market in this sector since the 2008 recession has been extremely sluggish. In the United Kingdom there have been several corporate failures and major restructures that have generated large scale redundancies, posing questions about the future of the high street. This paper examines the labour market transitions of workers displaced from jobs in the retail sector. Many return to work quite quickly, but most of these find new employment outside retail. Individual characteristics associated with a speedy return to work are examined in a competing risks framework. [ABSTRACT FROM AUTHOR]

Currently available risk prediction methods are limited in their ability to deal with complex, heterogeneous, and longitudinal data such as that available in primary care records, or in their ability to deal with multiple competing risks. This paper develops a novel deep learning approach that is able to successfully address current limitations of standard statistical approaches such as landmarking and joint modeling. Our approach, which we call Dynamic-DeepHit, flexibly incorporates the available longitudinal data comprising various repeated measurements (rather than only the last available measurements) in order to issue dynamically updated survival predictions for one or multiple competing risk(s). Dynamic-DeepHit learns the time-to-event distributions without the need to make any assumptions about the underlying stochastic models for the longitudinal and the time-to-event processes. Thus, unlike existing works in statistics, our method is able to learn data-driven associations between the longitudinal data and the various associated risks without underlying model specifications. We demonstrate the power of our approach by applying it to a real-world longitudinal dataset from the U.K. Cystic Fibrosis Registry, which includes a heterogeneous cohort of 5883 adult patients with annual follow-ups between 2009 to 2015. The results show that Dynamic-DeepHit provides a drastic improvement in discriminating individual risks of different forms of failures due to cystic fibrosis. Furthermore, our analysis utilizes post-processing statistics that provide clinical insight by measuring the influence of each covariate on risk predictions and the temporal importance of longitudinal measurements, thereby enabling us to identify covariates that are influential for different competing risks. [ABSTRACT FROM AUTHOR]

Manning difficulties and retention of skilled personnel is a timely issue in the British armed forces, and especially in the all-volunteer Royal Navy. Allied with difficulties of matching personnel numbers and posts, significant skill mismatches can take a long time to eradicate, with obvious financial and operational penalties. In the light of these factors, a holistic understanding of the exit behaviour of naval personnel is vital for naval manpower planners. This paper analyses ratings' voluntary (quits) and involuntary (separation) exit patterns from the Royal Navy using an independent competing risks hazard regression analysis framework. The results show that both voluntary and involuntary exits are pro cyclical with respect to macroeconomic and labour market conditions for both male and female ratings. Male ratings are more likely to quit or separate due to a lack of promotion to higher ranks as compared with females. Male ratings are also more likely to quit as a result of a hectic operational tempo when compared with their female counterparts. Frequency of sea/shore deployments also seems to exert a significant effect with respect to quits and separation outcomes of both genders. In terms of marital status married males are less likely to quit compared with their unmarried male counterparts, whereas the opposite is the case for female ratings. [ABSTRACT FROM AUTHOR]

We investigate the performance of various survival analysis techniques applied to ten actual credit data sets from Belgian and UK financial institutions. In the comparison we consider classical survival analysis techniques, namely the accelerated failure time models and Cox proportional hazards regression models, as well as Cox proportional hazards regression models with splines in the hazard function. Mixture cure models for single and multiple events were more recently introduced in the credit risk context. The performance of these models is evaluated using both a statistical evaluation and an economic approach through the use of annuity theory. It is found that spline-based methods and the single event mixture cure model perform well in the credit risk context. [ABSTRACT FROM AUTHOR]

The increases in cohabitation and in childbearing within cohabitation raise questions about who marries. Most studies have found that childbearing within cohabitation is associated with disadvantage; here, we examine the role of relationship happiness and whether it helps to explain this association. Using the UK Household Longitudinal Study (2009–17), our competing risk hazard models follow respondents as they transition: (1) from cohabitation into marriage or childbearing; and (2) from marriage or cohabitation into childbearing. We find that marriage risks are highest among individuals who are happiest with their relationship. On average, the association between relationship quality and childbearing operates through marriage: the happiest individuals marry, and those who marry have children. While higher socio-economic status is weakly associated with marriage, conception, and separation, the associations do not differ by relationship happiness. The findings indicate that overall, relationship happiness appears to be most salient for transitions into marriage. [ABSTRACT FROM AUTHOR]

Background: Recommended cardiovascular disease (CVD) prediction tools do not account for competing mortality risk and over-predict incident CVD in older and multimorbid people. The aim of this study was to derive and validate a competing risk model (CRISK) to predict incident CVD and compare its performance to that of QRISK3 in UK primary care.Methods: We used UK linked primary care data from the Clinical Practice Research Datalink (CPRD) GOLD to identify people aged 25-84 years with no previous CVD or statin treatment split into derivation and validation cohorts. In the derivation cohort, we derived models using the same covariates as QRISK3 with Fine-Gray competing risk modelling alone (CRISK) and with Charlson Comorbidity score (CRISK-CCI) as an additional predictor of non-CVD death. In a separate validation cohort, we examined discrimination and calibration compared to QRISK3. Reclassification analysis examined the number of patients recommended for treatment and the estimated number needed to treat (NNT) to prevent a new CVD event.Results: The derivation and validation cohorts included 989,732 and 494,865 women and 946,784 and 473,392 men respectively. Overall discrimination of CRISK and CRISK-CCI were excellent and similar to QRISK3 (for women, C-statistic = 0.863/0.864/0.863 respectively; for men 0.833/0.819/0.832 respectively). CRISK and CRISK-CCI calibration overall and in younger people was excellent. CRISK over-predicted in older and multimorbid people although performed better than QRISK3, whilst CRISK-CCI performed the best. The proportion of people reclassified by CRISK-CCI varied by QRISK3 risk score category, with 0.7-9.7% of women and 2.8-25.2% of men reclassified as higher risk and 21.0-69.1% of women and 27.1-57.4% of men reclassified as lower risk. Overall, CRISK-CCI recommended fewer people for treatment and had a lower estimated NNT at 10% risk threshold. Patients reclassified as higher risk were younger, had lower SBP and higher BMI, and were more likely to smoke.Conclusions: CRISK and CRISK-CCI performed better than QRISK3. CRISK-CCI recommends fewer people for treatment and has a lower NNT to prevent a new CVD event compared to QRISK3. Competing risk models should be recommended for CVD primary prevention treatment recommendations. [ABSTRACT FROM AUTHOR]

Objective: To examine the predictive performance of the relevant guideline by the Royal College of Obstetricians and Gynaecologists (RCOG) for neonates that are small for gestational age (SGA), and to compare the performance of the RCOG guideline with that of our competing risks model for SGA. Design: Prospective observational study. Setting: Obstetric ultrasound departments in two UK maternity hospitals. Population: A total of 96 678 women with singleton pregnancies attending for routine ultrasound examination at 19–24 weeks of gestation. Methods: Risks for SGA for different thresholds were computed, according to the competing risks model using maternal history, second‐trimester estimated fetal weight, uterine artery pulsatility index and mean arterial pressure. The detection rates by the RCOG guideline scoring system and the competing risks model for SGA were compared, at the screen positive rate (SPR) derived from the RCOG guideline. Main outcome measures: Small for gestational age (SGA), <10th or <3rd percentile, for different gestational age thresholds. Results: At an SPR of 22.5%, as defined by the RCOG guideline, the competing risks model predicted 56, 72 and 81% of cases of neonates that are SGA, with birthweights of <10th percentile, delivered at ≥37, <37 and <32 weeks of gestation, respectively, which were significantly higher than the respective figures of 36, 44 and 45% achieved by the application of the RCOG guideline. The respective figures for neonates that were SGA with birthweights of <3rd percentile were 66, 79, 85 and 41, 45, 44%. Conclusion: The detection rate for neonates that were SGA with the competing risk approach is almost double than that obtained with the RCOG guideline. The competing risks approach for the prediction of SGA performs better than the existing RCOG guideline. The competing risks approach for the prediction of SGA performs better than the existing RCOG guideline. [ABSTRACT FROM AUTHOR]

Job exit of men over the age of forty is described and analysed using monthly observations derived from the 1988-89 UK Retirement Survey. A competing risks model is described and estimated. The results show that tenure and age determine transitions from a job to a new one, whereas those transitions from a job to unemployment are also determined by business cycle variables. [ABSTRACT FROM AUTHOR]

Background: The increasing incidence of diffuse large B-cell lymphoma (DLBCL) in ageing populations places a significant burden on healthcare systems. Co-morbidity, frailty, and reduced organ and physiological reserve contribute to treatment-related complications. The optimal dose intensity of R-CHOP to optimize outcome across different ages with variable frailty and comorbidity burden is unclear.Objectives and Methods: We examined the influence of intended (IDI) and relative (RDI) dose intensity of the combination of cyclophosphamide and doxorubicin, age and comorbidity on outcomes for DLBCL patients ≥70 years in a representative, consecutive cohort across eight UK centres (2009-2018). We determined predictors of survival using multivariable Cox regression, and predictors of recurrence before death using competing risks regression.Results: Porgression-free survival (PFS) and overall survival (OS) were significantly inferior in patients ≥80 vs. 70-79 years (P < 0.001). In contrast, 2-year cumulative relapse incidence, when accounting for non-relapse mortality as a competing risk, was no different between 70-79 vs. ≥80 years (P = 0.27) or comorbidity status (CIRS-G: 0-6 vs. >6) (P = 0.27). In 70-79 years, patients with an IDI ≥80% had a significantly improved PFS and OS (P < 0.001) compared to IDI < 80%. Conversely, in patients ≥80 years, there was no difference in PFS (P = 0.88) or OS (P = 0.75) according to IDI <80% vs. ≥80%. On multivariable analysis, when comparing by age, there was a significantly higher cumulative relapse rate for patients aged 70-79 years with an IDI <80% (vs. >80%) (P = 0.04) but not for patients ≥80 years comparing IDI (P = 0.32).Conclusion: 'R-mini-CHOP' provides adequate lymphoma-specific disease control and represents a reasonable treatment option in elderly patients ≥80 years aiming for cure. [ABSTRACT FROM AUTHOR]

Using the British Household Panel Survey 1990-2007, we estimate a discrete duration model of interregional migration in Great Britain. By exploiting retrospective information on residency we control for late entry as well as unobserved heterogeneity. We find considerable duration dependence in region of residence in the raw data, much of which disappears when controlling for observable and unobservable differences between individuals. We illustrate that the usual way of modelling the effect of regional variables on the propensity to migrate gives insignificant and unrobust results and we introduce a new competing risks technique. [ABSTRACT FROM AUTHOR]

In recent years a strategy of selective, symptom-based intervention of carious primary teeth has been developed amongst some British general dental practitioners. Practice-based studies appear to provide evidence that policies of restoration of symptomless carious primary teeth do not confer any significant benefits above those associated with non-restorative care. However, results from these studies contrast with those of many clinical trials and prospective studies of primary molar restorations. In the current investigation, cohort study data from 5,168 carious primary molar teeth from 2,654 British children aged 4–5 years at baseline, augmented with Dental Practice Board treatment data, was utilised to assess the effect of restorative treatment on the likelihood of carious teeth subsequently progressing to either exfoliation or extraction. The effect of demographic and tooth level covariates on the fate of these teeth was also assessed. Multivariate multilevel parametric survival models were applied to the analysis of the carious-exfoliation and carious-extraction transitions to which the teeth were subject, assuming an underlying data hierarchy with teeth nested within individuals. Time of occurrence of caries affected survival experience, with teeth in which caries occurred later in life being associated with higher survival rates to extraction. Amongst filled teeth, later fillings were also associated with higher survival rates to extraction. Demographic and tooth level variables had a limited effect on survival experience. Treatment was found to be significantly associated with survival with respect to extraction, with survival rates of over 80% at 14 years, double those of untreated teeth. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

We analyse the decision to drop out of post-compulsory education over the period 1985–1994 using data from the Youth Cohort Surveys. We show that the dropout rate declined between 1985 and 1994, in spite of the rising participation rate in education, but is still substantial. Dropping out is more or less constant over the period of study, though the risk of dropout does vary with young people’s prior attainment, ethnicity, family background and the state of the labour market. The course of study has a substantial effect on the risk of dropout. [ABSTRACT FROM AUTHOR]

We investigate the effect of parenthood on whether non-marital unions led to marriage or parting for two cohorts of British women when they were aged between 16 and 29. We compare the effect of conceptions leading to births and the presence and characteristics of children on the odds that a cohabitation was dissolved, or that it was converted to marriage, for women born in 1958 and 1970. A multilevel, multiprocess, competing-risks model allows for multiple cohabitations per woman and endogeneity of fertility status. We find that cohabiting couples’ response to impending parenthood and the presence of children changed over time. In particular, the proportion of cohabiting couples who married before a birth decreased and, in the 1970 cohort only, the risk of dissolution declined during pregnancy. There is also evidence that the presence of a child cemented a cohabiting union for women from the 1970, but not the earlier, cohort. [ABSTRACT FROM AUTHOR]

From individual level longitudinal data for two entire cohorts of medical students in UK universities, we use multilevel models to analyse the probability that an individual student will drop out of medical school. We find that academic preparedness—both in terms of previous subjects studied and levels of attainment therein—is the major influence on withdrawal by medical students. Additionally, males and more mature students are more likely to withdraw than females or younger students respectively. We find evidence that the factors influencing the decision to transfer course differ from those affecting the decision to drop out for other reasons. [ABSTRACT FROM AUTHOR]

Background: Continuous monitoring of surgical outcomes after joint replacement is needed to detect which brands' components have a higher than expected failure rate and are therefore no longer recommended to be used in surgical practice. We developed a monitoring method based on cumulative sum (CUSUM) chart specifically for this application.Methods: Our method entails the use of the competing risks model with the Weibull and the Gompertz hazard functions adjusted for observed covariates to approximate the baseline time-to-revision and time-to-death distributions, respectively. The correlated shared frailty terms for competing risks, corresponding to the operating unit, are also included in the model. A bootstrap-based boundary adjustment is then required for risk-adjusted CUSUM charts to guarantee a given probability of the false alarm rates. We propose a method to evaluate the CUSUM scores and the adjusted boundary for a survival model with the shared frailty terms. We also introduce a unit performance quality score based on the posterior frailty distribution. This method is illustrated using the 2003-2012 hip replacement data from the UK National Joint Registry (NJR).Results: We found that the best model included the shared frailty for revision but not for death. This means that the competing risks of revision and death are independent in NJR data. Our method was superior to the standard NJR methodology. For one of the two monitored components, it produced alarms four years before the increased failure rate came to the attention of the UK regulatory authorities. The hazard ratios of revision across the units varied from 0.38 to 2.28.Conclusions: An earlier detection of failure signal by our method in comparison to the standard method used by the NJR may be explained by proper risk-adjustment and the ability to accommodate time-dependent hazards. The continuous monitoring of hip replacement outcomes should include risk adjustment at both the individual and unit level. [ABSTRACT FROM AUTHOR]