Adjusted restricted mean survival times in observational studies.

Abstract:

:In observational studies with censored data, exposure-outcome associations are commonly measured with adjusted hazard ratios from multivariable Cox proportional hazards models. The difference in restricted mean survival times (RMSTs) up to a pre-specified time point is an alternative measure that offers a clinically meaningful interpretation. Several regression-based methods exist to estimate an adjusted difference in RMSTs, but they digress from the model-free method of taking the area under the survival function. We derive the adjusted RMST by integrating an adjusted Kaplan-Meier estimator with inverse probability weighting (IPW). The adjusted difference in RMSTs is the area between the two IPW-adjusted survival functions. In a Monte Carlo-type simulation study, we demonstrate that the proposed estimator performs as well as two regression-based approaches: the ANCOVA-type method of Tian et al and the pseudo-observation method of Andersen et al. We illustrate the methods by reexamining the association between total cholesterol and the 10-year risk of coronary heart disease in the Framingham Heart Study.

journal_name

Stat Med

journal_title

Statistics in medicine

authors

Conner SC,Sullivan LM,Benjamin EJ,LaValley MP,Galea S,Trinquart L

doi

10.1002/sim.8206

subject

Has Abstract

pub_date

2019-09-10 00:00:00

pages

3832-3860

issue

20

eissn

0277-6715

issn

1097-0258

journal_volume

38

pub_type

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