Introduction to Survival Analysis.pptVIP

Introduction to Survival AnalysisOctober 19, 2004 Brian F. Gage, MD, MSc with thanks to Bing Ho, MD, MPH Division of General Medical Sciences Presentation goals Survival analysis compared w/ other regression techniques What is survival analysis When to use survival analysis Univariate method: Kaplan-Meier curves Multivariate methods: Cox-proportional hazards model Parametric models Assessment of adequacy of analysis Examples Regression vs. Survival Analysis What is survival analysis? Model time to failure or time to event Unlike linear regression, survival analysis has a dichotomous (binary) outcome Unlike logistic regression, survival analysis analyzes the time to an event Why is that important? Able to account for censoring Can compare survival between 2+ groups Assess relationship between covariates and survival time Importance of censored data Why is censored data important? What is the key assumption of censoring? Types of censoring Subject does not experience event of interest Incomplete follow-up Lost to follow-up Withdraws from study Dies (if not being studied) Left or right censored When to use survival analysis Examples Time to death or clinical endpoint Time in remission after treatment of disease Recidivism rate after addiction treatment When one believes that 1+ explanatory variable(s) explains the differences in time to an event Especially when follow-up is incomplete or variable Relationship between survivor function and hazard function Survivor function, S(t) defines the probability of surviving longer than time t this is what the Kaplan-Meier curves show. Hazard function is the derivative of the survivor function over time h(t)=dS(t)/dt instantaneous risk of event at time t (conditional failure rate) Survivor and hazard functions can be converted into each other Approach to survival analysis Like other statistics we have studied we can do any of the following w/ survival analysis: Descriptive statistics Univariate statistics Multivariate stati