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Survival Analysis Part II: Multivariate data analysis – an introduction to concepts and methods
Open accessAbstract
Survival analysis involves the consideration of the time between a fixed starting point (e.g. diagnosis of cancer) and a terminating event (e.g. death). The key feature that distinguishes such data from other types is that the event will not necessarily have occurred in all individuals by the time the study ends, and for these patients, their full survival times are unknown. For instance, in studies that measure the length of survival after diagnosis of cancer, it is common for a proportion of individuals to remain alive and disease-free at the end of the follow-up period, and for these patients, we know only a lower limit on their actual time to event. Thus, special methods are required for these type of data. The explanation and demonstration of some of the methods proposed to analyse such data are the basis of this series.
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“The proportional hazards assumption was assessed using the log(−log(survival)) plot, and those that failed the assumption or that were deemed to be time dependent were entered as continuous time-dependent covariates (Bradburn et al, 2003).”
From Cohort study of adherence to adjuvant endocrine therapy, breast cancer recurrence and mortality (2013) · cites this paper as Bradburn et al, 2003
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MethodSurvival analysis of a liquefiable embankment subjected to sequential earthquakes
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Brief introduction to parametric time to event model
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Does Size Matter for IPO Survival? Empirical Evidence from India
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“Figures 5 and 6 clearly show a straight line and validate the applicability of log-logistic form for AFT model (Bradburn et al., 2003; Kleinbaum & Klein, 2005, p. 279).”
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“Each covariate within the model is assumed to act multiplicatively (i.e., proportionally) on the baseline mortality hazard at each time step (e.g., Bradburn et al., 2003), such that: where h0 refers to the baseline hazard (i.e., the hazard's value when all covariate values are null), p denotes the…”
BackgroundCardiovascular risk prediction model for Omanis with type 2 diabetes
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COVID-19 Mortality Risk Factors Using Survival Analysis: A Case Study of Jakarta, Indonesia
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“The classical survival analysis using CPH requires PH assumption to be fulfilled, which is prone to the violation for several covariates [28], [29].”
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Studies Investigating Prognostic Factors: Conduct and Evaluation
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Habitat and morphological characteristics affect juvenile mortality in five coral reef damselfishes
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“The effect size, determined by 1-HR (see Bradbury et al. 2003), is denoted as odds ratios (OR).”
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“First is its requirement for proportional hazards (PH) between compared groups, implying that treatment effects on mor-talityremainconstantovertime 5,6 .”
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Regression modeling of time-to-event data with censoring
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“The method is particularly used in medical research, where survival time or time to relapse is under consideration (Bradburn et al., 2003a, 2003b; Clark et al., 2003a, 2003b).”
MethodNo Easy Way Out: One Community's Efforts to House Families Experiencing Homelessness
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Modeling time-to-trigger in library demand-driven acquisitions via survival analysis
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Group contracts and sustainability: Experimental evidence from smallholder seed production
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Genotoxicity Assay for Gene Therapy Vectors in Tumor Prone Cdkn2a−/− Mice
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“Time ratios derived from accelerated failure time models provide an altogether different measure of impact of the risk factor: They quantify by how much the time until occurrence of the event is shortened (time ratio below 1) or prolonged (time ratio above 1) compared with the reference group (22).”
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“Univariate models assessed the impact of covariates, and multivariate model measured the impact of other covariates when the risk was estimated for the one factor after adjustment.(37) The proportionality What is already known about this topic? � Patients with primary invasive melanoma are at increased risk of develop…”
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“As such, Akaike information criterion (AIC) values are used to select accelerated failure time models following different distributions (Bradburn et al. 2003b); AIC values weigh the goodness of fit of a model against its complexity and measure the degree to which the model explains the data.”
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“Survival analysis is typically concerned with the time between a starting point and a terminating event, although the terminating event will not have occurred for all cases by the end of the study period (Bradburn et al. 2003).”
Multimodal data fusion of adult and pediatric brain tumors with deep learningPreprint
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“Not assuming an underlying distribution of survival times combined with its multivariate nature makes Cox-PH widely accepted as the method of choice to model cancer prognosis and to compare survival characteristics between different groups [9].”
Examining network entry decisions in healthcare: Network and organizational characteristics
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“Other variables were selected based on univariate screening ( P 0.05) followed by backward stepwise regression with a retention criterion of P 0.05 [23].”
InfluentialWeaving, H., Terblanche, J. S., & English, S. (2023) · Journal of Thermal Biology · doi:10.1016/j.jtherbio.2023.103745 · Cited by 9
“We started from a maximal model and each term was excluded and removed if it did not significantly improve model fit (Bradburn et al., 2003).”
Factors associated with postpartum family planning use in Rwanda
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Exceptional Survival Model Mining
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“The Cox regression model allows the underlying hazard to be determined non-parametrically by the data (Bradburn et al., 2003; Cox & Oakes, 1984).”
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Rate advancement measurement for lung cancer and pleural mesothelioma in asbestos-exposed workers
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“Generally, survival analysis starts from data description and exploration by plotting Kaplan-Meier (KM) curves, and then compares survival curves; finally, univariable and multivariable regressions are performed to obtain effects of one or more factors [2].”
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“tors correlated with poor survival.(15) All variables for which data were”
BackgroundWhat is the best method for long-term survival analysis?
Bekiroglu, G. N., Avcı, E., & Özgür, E. G. (2022) · Indian Journal of Cancer · doi:10.4103/ijc.ijc_22_21 · Cited by 6
Foster carers influence brood pathogen resistance in ants
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SURVIVAL ANALYSIS FOR THE RISK OF DEVELOPING HEART ATTACK
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“Mathematically, the Cox model is written as [17]: H(t) = h0(t) × exp{b1x1 + b2x2 + ⋯+ bpxp} Where the hazard function H(t) is dependent on a set of p covariates (x1, x2, .”
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Hane, M. E., Kroll, A. J., Springford, A., Giovanini, J. N., Rochelle, M., & Arnett, E. B. (2018) · Forest Ecology and Management · doi:10.1016/j.foreco.2018.10.047 · Cited by 6
Contribution of artificial intelligence to the knowledge of prognostic factors in Hodgkin's lymphoma
Buciński, A., Marszałł, M. P., Krysiński, J., Lemieszek, A., & Załuski, J. (2010) · European Journal of Cancer Prevention · doi:10.1097/cej.0b013e32833ad353 · Cited by 6
“However, misuses of ANNs in oncology are common and the involvement of an experienced statistician in their use is advisable (Schwarzer et al. , 2000; Clark et al. , 2003).”
BackgroundMethodLockup Agreements and Survival of IPO FirmsPreprint
Ahmad, W. (2012) · SSRN Electronic Journal · doi:10.2139/ssrn.2134880 · Cited by 6
Osteosarcoma of the mobile spine: a single-institution experience of 32 patients
Gasho, J. O., Desai, V., Lozano‐Calderón, S. A., Nielsen, G. P., Hung, Y. P., Schwab, J. H., & Tobert, D. G. (2025) · The Spine Journal · doi:10.1016/j.spinee.2025.03.017 · Cited by 6
Breast Cancer in Pregnant Young Women: Clinicopathological Profile, Survival, and Pregnancy Outcomes
Ramírez-Torres, N., Rivas-Ruíz, R., & Reyes‐López, A. (2023) · Cureus · doi:10.7759/cureus.47578 · Cited by 5
“Molecular classification by IHC was described according to commonly accepted definitions [19,20].”
MethodMultimodal Deep Learning for Cancer Survival Prediction: A Review
Zhang, G., Ma, C., Yan, C., Luo, H., Wang, J., Liang, W., & Luo, J. (2024) · Current Bioinformatics · doi:10.2174/0115748936289033240424071522 · Cited by 5
Zubair, H., Susilawati, S., Talei, A., & Pu, Z. (2024) · Transportation Research Part A Policy and Practice · doi:10.1016/j.tra.2024.104229 · Cited by 5
Özler, T., Coşar, R., Süt, N., Nurlu, D., Parlar, Ş. E., Ateş, S., Dertli, M. H., Kavuzlu, Y., Kavukcu, S., Chousein, M., et al. (2025) · Breast Cancer Research and Treatment · doi:10.1007/s10549-024-07606-1 · Cited by 5
“Then, multivariate Cox regression analysis with a back-ward stepwise method was performed to estimate hazard ratios and identify independent prognostic factors [18].”
Predicting time-to-first cancer diagnosis across multiple cancer types
Lau, K., Hart, G. R., & Deng, J. (2025) · Scientific Reports · doi:10.1038/s41598-025-08790-w · Cited by 5
“In the Cox proportional hazards model, coefficients quantify the effect of each feature on survival, making these effect sizes clinically interpretable 32,33 .”
Li, C.-J., & He, P. (2022) · Discrete Dynamics in Nature and Society · doi:10.1155/2022/1154295 · Cited by 5
“[46], the mediating effect was tested by a series of chi-square difference tests.”
BackgroundMethodRetractedWeaving, H., Lord, J., Haines, L. R., & English, S. (2023) · Ecology and Evolution · doi:10.1002/ece3.10652 · Cited by 5
“The ‘drop one’ method was used whereby, starting from a maximal model, each term is excluded and removed if it does not significantly improve model fit (Bradburn et al., 2003).”
MethodSauenram, N., Sillabutra, J., Viwatwongkasem, C., & Satitvipawee, P. (2023) · Osong Public Health and Research Perspectives · doi:10.24171/j.phrp.2023.0084 · Cited by 6
“Parametric models provide more informative and precise estimates when the distribution is accurately specified, as compared to the Cox model [ 32 ,59].”
Shy albatross Thalassarche cauta chick mortality and heat stress in a temperate climate
Mason, C., Hobday, A. J., Alderman, R., & Lea, M. (2023) · Marine Ecology Progress Series · doi:10.3354/meps14494 · Cited by 5
Using nurse-led rounds to improve quality measures related to HAPUs
Fisher, K., Grosh, A., & Felty, V. (2016) · Nursing · doi:10.1097/01.nurse.0000494657.67378.00 · Cited by 5
Carstens, H., Xia, X., Yadavalli, V. S. S., & Rajan, A. (2017) · Energy and Buildings · doi:10.1016/j.enbuild.2017.04.084 · Cited by 5
Removing administrative boundaries using a gravity model for a national liver allocation system
Bayer, F., Audry, B., Antoine, C., Jasseron, C., Legeai, C., Bastien, O. H., & Jacquelinet, C. (2020) · American Journal of Transplantation · doi:10.1111/ajt.16214 · Cited by 5
Assessment of lung cancer risk factors and mortality in Qatar: A case series study
Abdel‐Salam, A. G., Mollazehi, M., Bandyopadhyay, D., Malki, A. M., Shi, Z., & Zayed, H. (2020) · Cancer Reports · doi:10.1002/cnr2.1302 · Cited by 5
Siméon, S., Beaudouin, R., Brotzmann, K., Braunbeck, T. A., & Bois, F. Y. (2021) · Toxicology and Applied Pharmacology · doi:10.1016/j.taap.2021.115424 · Cited by 5
Casagrande, E., Génard, M., Lurol, S., Charles, F., Bevacqua, D., Martinetti, D., & Lescourret, F. (2022) · Phytopathology · doi:10.1094/phyto-12-21-0499-r · Cited by 5
Chaipattanawan, N., Chompu‐inwai, P., Manmontri, C., Cherdsatirakul, P., Nirunsittirat, A., & Phinyo, P. (2023) · European Endodontic Journal · doi:10.14744/eej.2022.18894 · Cited by 5
“This regression model is the statistical technique used for exploring the relationship between the survival outcome and potential risk variables (24).”
MethodA systems biology‐based approach to screen key splicing factors in hepatocellular carcinoma
Zhu, R., Wang, X., Yu, Q., Guo, W., & Zhu, L. (2023) · Molecular Carcinogenesis · doi:10.1002/mc.23549 · Cited by 5
CESCProg: a compact prognostic model and nomogram for cervical cancer based on miRNA biomarkers
Muthamilselvan, S., & Palaniappan, A. (2023) · PeerJ · doi:10.7717/peerj.15912 · Cited by 5
Passantino, A., Guida, P., Parisi, G., Iacoviello, M., & Scrutinio, D. (2017) · Advances in experimental medicine and biology · doi:10.1007/5584_2017_135 · Cited by 5
“…in order to avoid bias, some relevant issues should be considered: the representativeness of the population of interest, the accuracy of dataset, the missing values handling, the sample size, the number of observed events and the number of predictors (Royston et al. 2009; Bradburn et al. 2003).”
Background
Metadata
- Authors
- Bradburn, M. J., Clark, T. G., Love, S. B., & Altman, D. G.
- Affiliations
- Cancer Research UK (GB)
- Corresponding author
- Bradburn, M J
- Venue
- British Journal of Cancer
- Published
- 2003-07-29
- Volume
- 89
- Issue
- 3
- Pages
- 431-436
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC2394368
- OpenAlex
- W2107482271
- Cited by
- 741
- References
- 16
- Citations by year
- 2026: 31 · 2025: 55 · 2024: 86 · 2023: 67 · 2022: 54 · 2021: 91 · 2020: 55 · 2019: 41 · 2018: 43 · 2017: 35 · 2016: 26 · 2015: 21 · 2014: 27 · 2013: 15 · 2012: 24
- FWCI
- 7.17
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- www.springer.com/tdm (unspecified)
- Locations
- British Journal of Cancer (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Funders
- Cancer Research UK
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods and Inference
- Physical Sciences › Mathematics › Statistics and Probability › Probability and Statistical Research
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Distribution Estimation and Applications
- Keywords
- survival analysis, multivariate survival data, censored data, time to event, cancer survival, censoring
- MeSH terms
- Clinical Trials as Topic, Humans, Neoplasms, Models, Statistical, Multivariate Analysis, Survival Analysis
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