When do we need competing risks methods for survival analysis in nephrology?
When do we need competing risks methods for survival analysis in nephrology?
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DOI：
10.1093/ndt/gft355
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发表时间：
2013-11-01
影响因子：
6.1
通讯作者：
Jager, Kitty J.
中科院分区：
文献类型：
--
作者：
Noordzij, Marlies;Leffondre, Karen;Jager, Kitty J.
生存分析通常用于研究死亡或其他感兴趣的事件。在这种分析中，所谓的竞争风险可能构成一个重要问题。竞争风险是指阻碍对感兴趣事件的观察或改变该事件发生的可能性的事件。例如，在研究透析死亡时，接受肾移植是一个与感兴趣的事件竞争的事件。忽略竞争事件(S)的传统生存分析方法，如Kaplan Meier方法和标准的COX比例风险回归方法，在存在竞争风险的情况下可能是不合适的，然后应该应用专门为分析竞争风险数据而设计的替代方法。这一问题在肾脏病研究中值得更多的关注，因此，在本文中，我们解释了生存分析中的竞争风险问题，以及使用不同的技术可能会如何影响研究结果。
Survival analyses are commonly applied to study death or other events of interest. In such analyses, so-called competing risks may form an important problem. A competing risk is an event that either hinders the observation of the event of interest or modifies the chance that this event occurs. For example, when studying death on dialysis, receiving a kidney transplant is an event that competes with the event of interest. Conventional methods for survival analysis ignoring the competing event(s), such as the KaplanMeier method and standard Cox proportional hazards regression, may be inappropriate in the presence of competing risks, and alternative methods specifically designed for analysing competing risks data should then be applied. This problem deserves more attention in nephrology research and in the current article, we therefore explain the problem of competing risks in survival analysis and how using different techniques may affect study results.