Comparison of different approaches to estimating age standardized net survival
Comparison of different approaches to estimating age standardized net survival
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DOI：
10.1186/s12874-015-0057-3
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发表时间：
2015-08-15
影响因子：
4
通讯作者：
Rutherford, Mark J.
中科院分区：
文献类型：
--
作者：
Lambert, Paul C.;Dickman, Paul W.;Rutherford, Mark J.
背景：年龄标准化净生存率提供了基于人群的癌症生存率的重要总结，它适当地解释了其他原因死亡率的差异，并对人口年龄分布进行标准化，以便进行公平比较。最近，对于估计该数量的最合适方法存在争议，传统的 Ederer II 方法被证明存在潜在偏差。方法：我们比较基于生命表的估计 (Ederer II)、一种基于审查权重逆概率 (Pohar Perme) 的新无偏方法和基于模型的估计。我们在模拟环境中进行比较；结果：我们的模拟表明，即使在相对极端的情况下，使用年龄标准化 Ederer II 方法、连续年龄建模或使用 Pohar Perme 方法时，年龄标准化净生存率的偏差也可以忽略不计。然而，Ederer II 和建模方法在精度更高方面都比 Pohar Perme 方法有一些优势，特别是对于长期随访（10 和 15 年）。 结论：我们的结果表明，在年龄标准化时，对传统方法偏差的担忧是没有根据的。我们还展示了使用更传统的建模方法的优势。
Background: Age-standardized net survival provides an important population-based summary of cancer survival that appropriately accounts for differences in other-cause mortality rates and standardizes the population age distribution to allow fair comparisons. Recently, there has been debate over the most appropriate method for estimating this quantity, with the traditional Ederer II approach being shown to have potential bias.Methods: We compare lifetable-based estimates (Ederer II), a new unbiased method based on inverse probability of censoring weights (Pohar Perme) and model-based estimates. We make the comparison in a simulation setting; generating scenarios where we would expect to see a large theoretical bias.Results: Our simulations demonstrate that even in relatively extreme scenarios there is negligible bias in age-standardized net survival when using the age-standardized Ederer II method, modelling with continuous age or using the Pohar Perme method. However, both the Ederer II and modelling approaches have some advantages over the Pohar Perme method in terms of greater precision, particularly for longer-term follow-up (10 and 15 years).Conclusions: Our results show that, when age-standardizing, concern over bias with the traditional methods is unfounded. We have also shown advantages in using the more traditional and modelling methods.