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Understanding Survival Analysis in Healthcare

Survival analysis is a set of statistical methods used to analyze longitudinal data involving events, such as death, disease onset or recovery. It can be used to estimate the time until an event occurs for individuals or groups, compare time-to-event between groups, and assess how factors influence survival time. Survival analysis accommodates data from clinical trials or cohort studies and accounts for censoring, where subjects are lost to follow up before an event. The objectives are to estimate time-to-event, compare times between groups, and assess how covariates relate to time-to-event.

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135 views7 pages

Understanding Survival Analysis in Healthcare

Survival analysis is a set of statistical methods used to analyze longitudinal data involving events, such as death, disease onset or recovery. It can be used to estimate the time until an event occurs for individuals or groups, compare time-to-event between groups, and assess how factors influence survival time. Survival analysis accommodates data from clinical trials or cohort studies and accounts for censoring, where subjects are lost to follow up before an event. The objectives are to estimate time-to-event, compare times between groups, and assess how covariates relate to time-to-event.

Uploaded by

NehaKarunya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd

What is survival analysis?

 Statistical methods for analyzing longitudinal data


on the occurrence of events. Usage In specific to
Healthcare sector
 Events may include death, injury, onset of illness,
recovery from illness (binary variables) or
transition above or below the clinical threshold of a
meaningful continuous variable (e.g. CD4 counts).
 Accommodates data from randomized clinical trial
or cohort study design.

1
Examples of survival analysis
in medicine

2
RCT: Women’s Health
Initiative (JAMA, 2002)

On hormones

Cumulative
incidence On placebo

Women’s Health Initiative


Writing Group.
JAMA. 2002;288:321-333. 3
WHI and low-fat diet…
Control

Low-fat diet

Prentice et al.
JAMA, February 8,
2006; 295: 629 -
642. 4
Objectives of survival analysis
 Estimate time-to-event for a group of
individuals/objects, such as time until second
heart-attack for a group of MI patients (for our use
case time until second loop gets triggered)
 To compare time-to-event between two or

more groups, such as treated vs. placebo MI


patients in a randomized controlled trial.
 To assess the relationship of co-variables to

time-to-event, such as: does weight, insulin


resistance, or cholesterol influence survival time of
MI patients?
Note: expected time-to-event = 1/incidence rate

5
Why use survival analysis?
1. Why not compare mean time-to-event
between your groups using a t-test or
linear regression?
-- ignores censoring
2. Why not compare proportion of events
in your groups using risk/odds ratios or
logistic regression?
--ignores time

6
Survival Analysis: Terms
 Time-to-event: The time from entry into a
study until a subject has a particular outcome
 Censoring: Subjects are said to be censored
if they are lost to follow up or drop out of the
study, or if the study ends before they die or
have an outcome of interest. They are
counted as alive or disease-free for the time
they were enrolled in the study.
 If dropout is related to both outcome and
treatment, dropouts may bias the results

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