What question did this study set out to answer?

To review the relationship between rate and risk in survival analysis and clarify key methodological pitfalls when evaluating competing risks.

January 9, 2012International Journal of EpidemiologyOpen Access

Competing risks in epidemiology: possibilities and pitfalls

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Authors

PAPer Kragh AndersenUniversity of Copenhagen RGRonald B. GeskusAngkor Hospital for Children TWThéo de WitteRadboud University Nijmegen

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Implication

Methodological review reveals the loss of rate-risk correspondence in competing risks survival analysis, highlighting biases in standard Kaplan-Meier estimation.

Key Points

To review the relationship between rate and risk in survival analysis and clarify key methodological pitfalls when evaluating competing risks.
Reviewed mathematical relationships connecting hazard rates and cumulative risk in all-cause mortality versus competing risks settings.
Demonstrated analytical distinctions between cause-specific hazards and cumulative incidence functions using an illustrative stem cell transplantation dataset comparing relapse and non-relapse mortality.
The direct one-to-one correspondence between cause-specific hazard (rate) and cumulative incidence (risk) is lost when competing events occur.
Standard Kaplan-Meier analysis treating competing events as censored observations produces upwardly biased risk estimates.
Covariates associated with cause-specific hazards can show divergent directions or magnitudes of association with cumulative incidence.

Cite This Study

Andersen et al. (2012) studied this question.

synapsesocial.com/papers/69f14bb92811130d0cde22dd https://doi.org/10.1093/ije/dyr213

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Implication

Methodological review reveals the loss of rate-risk correspondence in competing risks survival analysis, highlighting biases in standard Kaplan-Meier estimation.

Competing risks in epidemiology: possibilities and pitfalls

Discussion

Member takes

Implication

Key Points

Cite This Study

Competing risks in epidemiology: possibilities and pitfalls

Discussion

Member takes

Implication

Key Points

Cite This Study

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