33051-33061

33051-33061 - Introduction to Survival Analysis Kristin...

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1 Introduction to Survival Analysis Kristin Sainani Ph.D. http://www.stanford.edu/~kcobb Stanford University Department of Health Research and Policy
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2 Overview What is survival analysis? Terminology and data structure. Survival/hazard functions. Parametric versus semi-parametric  regression techniques. Introduction to Kaplan-Meier methods  (non-parametric). Relevant SAS Procedures (PROCS).
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3 Early example of survival  analysis, 1669 Christiaan Huygens' 1669 curve showing how many out of 100 people survive until 86 years. From: Howard Wainer - STATISTICAL GRAPHICS: Mapping the Pathways of Science . Annual Review of Psychology . Vol. 52: 305-335.
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4 Early example of survival  analysis Roughly, what shape  is this function? What was a person’s  chance of surviving  past 20? Past 36? This is survival analysis!  We are trying to estimate  this curve—only the  outcome can be any  binary event, not just  death.
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5 What is survival analysis? Statistical methods for analyzing longitudinal  data on the occurrence of events. 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.
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Randomized Clinical Trial  (RCT) Target population Intervention Control Disease Disease-free Disease Disease-free TIME Random  assignment Disease-free,  at-risk cohort
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Target population Treatment Control Cured Not cured Cured Not cured TIME Random  assignment Patient  population Randomized Clinical Trial  (RCT)
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Target population Treatment Control Dead Alive Dead Alive TIME Random  assignment Patient  population Randomized Clinical Trial  (RCT)
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Cohort study  (prospective/retrospective)  Target population Exposed Unexposed Disease Disease-free Disease Disease-free TIME Disease-free  cohort
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10 Examples of survival analysis  in medicine
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11 RCT: Women’s Health  Initiative ( JAMA , 2002) On hormones On placebo Cumulative  incidence Women’s Health Initiative  Writing Group.  JAMA . 2002;288:321-333. 
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12 WHI and low-fat diet… Control Low-fat diet Prentice et al.  JAMA , February  8, 2006; 295: 629  - 642.
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13 Retrospective cohort study: From December 2003  BMJ Aspirin, ibuprofen, and mortality after myocardial infarction:  retrospective cohort study   Curits et al.  BMJ   2003;327:1322-1323. 
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14 Estimate time-to-event for a group of  individuals , such as time until second heart- attack for a group of MI patients. To compare time-to-event between two or 
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33051-33061 - Introduction to Survival Analysis Kristin...

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