Survival Analysis Of Recurrent Events An Application To Diabetes Mellitus Patients In The Case Of Menellik Li Referral Hospital

Diabetes mellitus is a group of metabolic diseases characterized by elevated blood glucosernlevels (hyperglycemia) resulting from defects in insulin discharge, insulin action or both.rnRecovery to normal blood sugar level in DM patients often is recurrent and correlation betweenrnevents needs to be taken into account during analysis of such data. The main objectives of thisrnresearch were to analysis time to recovery of DM patients and make a comparison betweenrnstandard Cox-proportional Hazard (PH) and Frailty models. To achieve the objectives of the study,rna retrospective data were obtained from Menellik II Referral Hospital chronic patient’s clinic. Allrndiabetes patients of over 15 years of age and who were under treatment between 2009 and 2015rnwere included in the study. Unmeasured shared similarities due to the impact of multiple eventsrnwere modeled using a random effect (Frailty) term. The Likelihood Cross Validation (LCV)rncriteria were used for comparison between the Standard Cox PH and Frailty model. Shared Log-rnNormal Frailty model had a minimum value of LCV than the Cox PH and shared Gamma Frailtyrnmodels. Hence, the shared log-normal Frailty model was chosen for analysis of the recurrent eventrnof time to recovery of DM patients in Menellik II Referral Hospital. The median recovery time ofrnDM patients was 32 weeks. The patient’s sex and Regimen groups at baseline were significantlyrnassociated with recurrent event of time to recovery of DM patients.rnKey Words: Recurrent events, Frailty, Gamma, Log-normal, LCV, Penalized MarginalrnLikelihood

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