Competing Risk: 1 Method One. Cox PH Model
Competing Risk: 1 Method One. Cox PH Model
Competing Risk: 1 Method One. Cox PH Model
Ana Teresa Yanes Musetti, Edgar Alan Muro Jimenez and Abel Camacho Guardian
Statistic Seminar.
23-05-2011
"Competing risk occur when there are at least two possible ways that a person can fail, but
only one such failure type can actually occur."[1]
1
For C competing risks
h∗g (t, X) = h∗0g (t) exp[β1 X1 + ... + β1 Xp
+δ21 D2 X1 + ... + δ2p D2 Xp
+δ31 D3 X1 + ... + δ3p D3 Xp
+...
+δC1 DC X1 + ... + δCp DC Xp ]
Dc is a dummy variable which is equal to 1 for event type c and 0 otherwise, c ∈ {1, ..., C}.
In this case there is no dummy variable for event type 1, because it is the reference event.
For type of event 2, we get :
h∗2 (t, X) = h∗02 (t) exp[(β1 + δ21 )X1 + ... + (β1 + δ2p )Xp ]
The formula for the HR for the eect of X1 adjusted for the covariates is
HR2 (X1 = 1 vs. X1 = 0) = exp (β1 + δ21 ) (3)
0
HR2 (X1 = 1 vs. X1 = 0) = exp (δ2 ) (4)
2 Non-informative censoring.
Denition :[7] Non informative censoring is when each subject has a censoring time that is
statistically independent of their failure time.
[5] The probability of being censored for any subject in the risk set at time t does not depend
on that subject's prognosis for failure at time t.
(More general)[5] Each subject is representative of subjects in the risk set with the same values
of predictors.
Example. Our event of interest is time when a death of cancer occurs and our competing risk
is time when a death of cardiovascular occurs. Let Harry and Barry be two individuals in an
homogeneous group, there is non-informative censoring if the probability of being censored is the
same for both individuals, in particular this means that the probability of dying of the competing
risk is equal for both individuals.
It is not possible to determine whether the competing risks are independent.
2
3 Cumulative Incidence Curve.
(T, C)
T time at which the event of type i occurred, when C = i
T time at which the observation was censored, when C = 0.
Cumulative incidence function : The Probability that an event of type i occurs at or
before time t.
Fi (t) = P (T ≤ t, C = i)
CIC : estimates the "marginal probability" of an event type i in the presence of competing
risks. It is not required the independence of non-informative censoring.
X
F̂i (t) = hˆij Ŝ(tj−1 ) (5)
∀j:tj ≤t
dij
with hˆij = nj
It is required that
ht = hc1 (t) + hc2 (t) + ... + hck (t) (6)
The above equality is satised if the type of events are mutually exclusive (disjoint) and they
are non recurrent.
CICc
CP Cc = (8)
1 − CICc0
0
c denotes all type of events, but except c.
[1] Lunn M, McNeil D. Applying Cox regression to competing risks. Biometrics 1995 ; 51 :524532
[2] Pintilie M. Competing Risks : A Practical Perspective. John Wiley and Sons : New York,
2006, 240pp.
[3] J.Klein and M. Moeschberg, Survival Analysis : Techniques for Censored and Truncated
Data, Spring, second ed., 2003.
[4] G. Rodriguez, Competing Risks, 2005.
[5] Survival analysis : A self-learning text, Kleinbaum D.G. and Klein M., Springer 2005.
[7] http ://en.wikipedia.org/wiki/Censoring_(statistics)