Introduction to the Analysis of Survival Data in the Presence of Competing Risks

Austin, Peter C.; Lee, Douglas S.; Fine, Jason P.

doi:10.1161/circulationaha.115.017719

Cited by 1,745 publications

(1,700 citation statements)

References 20 publications

(28 reference statements)

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“…The models differ from each other in the way they handle competing events and by the type of hazard function they model on. Therefore, both models have different interpretations (28).…”

Section: Resultsmentioning

confidence: 99%

“…The risk ratio from the cause-specific Cox model (HR) does not translate verbatim to valid absolute risks, since in order to calculate these risks the cause-specific hazards of the competing events are also needed (32). However, for etiological questions, the cause-specific Cox model may be more appropriate, since the cause-specific hazard function represents the instantaneous rate of the event of interest among those still event free (28).…”

Section: Methodsological Approachesmentioning

confidence: 99%

“…When the independent variable would be associated with the event of interest in a way opposite to the competing events, the SHR would be higher than the HR from the Cox analysis. Furthermore, both measures are on a different scale: cause-specific hazard function and cumulative incidence function (28). The cause-specific model provides information about etiological relation, whereas the F&G model provides effect estimates which are directly transferable to absolute risks (28).…”

Section: Methodsological Approachesmentioning

confidence: 99%

See 2 more Smart Citations

The influence of poor health on competing exit routes from paid employment among older workers in 11 European countries

Reeuwijk

Klaveren²,

Rijn³

et al. 2016

Scand J Work Environ Health

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“…The models differ from each other in the way they handle competing events and by the type of hazard function they model on. Therefore, both models have different interpretations (28).…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsological Approachesmentioning

confidence: 99%

Section: Methodsological Approachesmentioning

confidence: 99%

See 1 more Smart Citation

The influence of poor health on competing exit routes from paid employment among older workers in 11 European countries

Reeuwijk

Klaveren²,

Rijn³

et al. 2016

Scand J Work Environ Health

View full text Add to dashboard Cite

show abstract

“…Cause-specific hazard models were used to address the competing risks of cardiovascular and non-cardiovascular death. 22 This approach is appropriate for addressing epidemiological questions of disease etiology. 23 We also found evidence that although engagement in a large variety of LTPA is beneficial in reducing mortality, the benefits are non-specific to cardiovascular health.…”

Section: Discussionmentioning

confidence: 99%

Leisure-Time Physical Activity and Cardiovascular Mortality in an Elderly Population in Northern Manhattan: A Prospective Cohort Study

et al. 2016

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BACKGROUND: Previous studies of exercise have focused on measuring physical activity in totality using summary statistics such as metabolic equivalent score for total intensity or total energy count. OBJECTIVE: We aimed to examine the multidimensionality of leisure-time physical activity (LTPA) and to identify the specific LTPA components that were associated with cardiovascular mortality in the elderly. DESIGN AND PARTICIPANTS: The Northern Manhattan Study (NOMAS) is a multiethnic prospective cohort of elderly stroke-free individuals consisting of a total of 3298 participants recruited between 1993 and 2001, with a median follow-up of 17 years. MAIN MEASURES: Physical activity questionnaire data were available in 3293 NOMAS participants, who were categorized into subgroups with similar exercise patterns by model-based cluster analysis. Three subgroupdefining LTPA features were identified and were considered as primary exposures in Cox proportional hazard models: frequency of activity, number of activity types (variety), and energy-to-duration ratio (EDR). We considered cardiovascular mortality and non-cardiovascular mortality as outcomes in Cox cause-specific proportional hazard models, and all-cause mortality as outcome in Cox models. KEY RESULTS: A high activity frequency was associated with reduced cardiovascular mortality (hazard ratio, HR = 0.93, P = 0.03), but demonstrated no effect on non-cardiovascular death. A high EDR was associated with increased risk of cardiovascular death (HR = 1.30, P = 0.01). A high number of activity types was beneficial in reducing all-cause mortality (HR = 0.87, P = 0.01). CONCLUSIONS: Exercise frequency was protective against cardiovascular mortality, and a high variety of activity was protective against all-cause mortality. The performance of frequent and varied non-intense exercise in an elderly population such as ours is achievable and can reduce the risk of death.

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“…Patients were followed forward from the VCF placement until the VCF was retrieved, they died, they were lost to follow‐up, or the end of the study period. The 30‐, 60‐, 90‐, 180‐day, and 1‐year cumulative incidence of VCF retrieval was estimated using Fine and Gray's time‐to‐event, survival analysis methodology, accounting for death as a competing risk 24. Time to VCF retrieval was also reported.…”

Section: Methodsmentioning

confidence: 99%

Vena Cava Filter Retrieval Rates and Factors Associated With Retrieval in a Large US Cohort

Brown

Raissi

Han

et al. 2017

JAHA

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BackgroundRetrieval of vena cava filters (VCFs) is important for safety as complications increase with longer dwell times. This study assessed VCF retrieval rates and factors associated with retrieval in a national cohort.Methods and Results VCFs were identified by procedural codes from an administrative claims database. Patients were identified who had a VCF placement during a hospitalization from a national commercial administrative claims database. Indications for VCF placement were identified as pulmonary embolism with or without deep vein thrombosis, deep vein thrombosis only, or prophylactic. Patient demographic and clinical characteristics were included in proportional hazard regression models to find associations with early (90‐day) and 1‐year VCF retrieval. Initiation of anticoagulation and the correlation between time‐to‐retrieval and time‐to‐initiation of anticoagulation were observed. Of 54 766 patients receiving a VCF, 36.9% had pulmonary embolism, 43.9% had deep vein thrombosis only, and 19.2% had no apparent venous thromboembolism present. Over the 1 year of follow‐up, the cumulative incidence of VCF retrieval was 18.4%. Retrieval increased over time from a low of 14.0% in 2010 up to ≈24% in 2014. In adjusted time‐to‐event models, increasing age, differing regions, and some comorbidities were associated with poorer retrieval rates. Initiation of anticoagulation was poorly correlated with retrieval, with anticoagulation preceding retrieval by a median of 51 days while those without retrieval had a median of 278 days of exposure to anticoagulation.Conclusions VCF retrieval increased over the study period but remained suboptimal and was weakly correlated with anticoagulation initiation.

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Introduction to the Analysis of Survival Data in the Presence of Competing Risks

Abstract: Supplemental Digital Content is available in the text.

Cited by 1,745 publications

References 20 publications

The influence of poor health on competing exit routes from paid employment among older workers in 11 European countries

The influence of poor health on competing exit routes from paid employment among older workers in 11 European countries

Leisure-Time Physical Activity and Cardiovascular Mortality in an Elderly Population in Northern Manhattan: A Prospective Cohort Study

Vena Cava Filter Retrieval Rates and Factors Associated With Retrieval in a Large US Cohort

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