Estimating the burden of recurrent events in the presence of competing risks: the method of mean cumulative count.

Abstract:

:Cumulative incidence has been widely used to estimate the cumulative probability of developing an event of interest by a given time, in the presence of competing risks. When it is of interest to measure the total burden of recurrent events in a population, however, the cumulative incidence method is not appropriate because it considers only the first occurrence of the event of interest for each individual in the analysis: Subsequent occurrences are not included. Here, we discuss a straightforward and intuitive method termed "mean cumulative count," which reflects a summarization of all events that occur in the population by a given time, not just the first event for each subject. We explore the mathematical relationship between mean cumulative count and cumulative incidence. Detailed calculation of mean cumulative count is described by using a simple hypothetical example, and the computation code with an illustrative example is provided. Using follow-up data from January 1975 to August 2009 collected in the Childhood Cancer Survivor Study, we show applications of mean cumulative count and cumulative incidence for the outcome of subsequent neoplasms to demonstrate different but complementary information obtained from the 2 approaches and the specific utility of the former.

journal_name

Am J Epidemiol

authors

Dong H,Robison LL,Leisenring WM,Martin LJ,Armstrong GT,Yasui Y

doi

10.1093/aje/kwu289

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

532-40

issue

7

eissn

0002-9262

issn

1476-6256

pii

kwu289

journal_volume

181

pub_type

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