Rare Event Approximation Between Subdistribution Hazard Ratio and Cause-specific Hazard Ratio in Survival Analysis With Competing Risks

Background: Despite the fact that competing risks are inevitable in epidemiological and clinical studies, distinctions between the hazard ratio estimated by handling competing risks as censoring and the subditribution hazard ratio are often overlooked. Methods: We derived quantitative relationships...

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Main Author: Shiro Tanaka
Format: Article
Language:English
Published: Japan Epidemiological Association 2024-12-01
Series:Journal of Epidemiology
Subjects:
Online Access:https://www.jstage.jst.go.jp/article/jea/34/12/34_JE20240063/_pdf
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author Shiro Tanaka
author_facet Shiro Tanaka
author_sort Shiro Tanaka
collection DOAJ
description Background: Despite the fact that competing risks are inevitable in epidemiological and clinical studies, distinctions between the hazard ratio estimated by handling competing risks as censoring and the subditribution hazard ratio are often overlooked. Methods: We derived quantitative relationships between subdistribution hazard ratio and cause-specific hazard ratio and derive an approximate calculation method to transform the two into each other. Numerical examinations of hypothetical six scenarios and published information of a randomized clinical trial of cholesterol-lowering therapy and a registry of acute myeloid leukemia were provided. Results: General and approximate relationships under rare event assumptions between the two types of hazard ratio were given. The approximation formula is based on a survival ratio and has two possible applications. First, one can calculate a subdistribution hazard ratio from published information. Second, this formula allows sample size estimation that takes the presence of competing risks into account. Conclusion: The distinction between the two types of hazard ratio can be addressed by focusing on two quantities. One is how the event of interest and competing risk is rare, and the other is the survival ratio.
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institution Kabale University
issn 0917-5040
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language English
publishDate 2024-12-01
publisher Japan Epidemiological Association
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series Journal of Epidemiology
spelling doaj-art-d0368c3e1d2d45a282c736748ebf36dc2024-12-05T01:45:42ZengJapan Epidemiological AssociationJournal of Epidemiology0917-50401349-90922024-12-01341259559910.2188/jea.JE20240063Rare Event Approximation Between Subdistribution Hazard Ratio and Cause-specific Hazard Ratio in Survival Analysis With Competing RisksShiro Tanaka0Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Kyoto, JapanBackground: Despite the fact that competing risks are inevitable in epidemiological and clinical studies, distinctions between the hazard ratio estimated by handling competing risks as censoring and the subditribution hazard ratio are often overlooked. Methods: We derived quantitative relationships between subdistribution hazard ratio and cause-specific hazard ratio and derive an approximate calculation method to transform the two into each other. Numerical examinations of hypothetical six scenarios and published information of a randomized clinical trial of cholesterol-lowering therapy and a registry of acute myeloid leukemia were provided. Results: General and approximate relationships under rare event assumptions between the two types of hazard ratio were given. The approximation formula is based on a survival ratio and has two possible applications. First, one can calculate a subdistribution hazard ratio from published information. Second, this formula allows sample size estimation that takes the presence of competing risks into account. Conclusion: The distinction between the two types of hazard ratio can be addressed by focusing on two quantities. One is how the event of interest and competing risk is rare, and the other is the survival ratio.https://www.jstage.jst.go.jp/article/jea/34/12/34_JE20240063/_pdfcompeting riskfine-gray modelsurvival analysiseffect measure
spellingShingle Shiro Tanaka
Rare Event Approximation Between Subdistribution Hazard Ratio and Cause-specific Hazard Ratio in Survival Analysis With Competing Risks
Journal of Epidemiology
competing risk
fine-gray model
survival analysis
effect measure
title Rare Event Approximation Between Subdistribution Hazard Ratio and Cause-specific Hazard Ratio in Survival Analysis With Competing Risks
title_full Rare Event Approximation Between Subdistribution Hazard Ratio and Cause-specific Hazard Ratio in Survival Analysis With Competing Risks
title_fullStr Rare Event Approximation Between Subdistribution Hazard Ratio and Cause-specific Hazard Ratio in Survival Analysis With Competing Risks
title_full_unstemmed Rare Event Approximation Between Subdistribution Hazard Ratio and Cause-specific Hazard Ratio in Survival Analysis With Competing Risks
title_short Rare Event Approximation Between Subdistribution Hazard Ratio and Cause-specific Hazard Ratio in Survival Analysis With Competing Risks
title_sort rare event approximation between subdistribution hazard ratio and cause specific hazard ratio in survival analysis with competing risks
topic competing risk
fine-gray model
survival analysis
effect measure
url https://www.jstage.jst.go.jp/article/jea/34/12/34_JE20240063/_pdf
work_keys_str_mv AT shirotanaka rareeventapproximationbetweensubdistributionhazardratioandcausespecifichazardratioinsurvivalanalysiswithcompetingrisks