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The Analysis of Failure Times in the Presence of Competing Risks
Abstract
Distinct problems in the analysis of failure times with competing causes of failure include the estimation of treatment or exposure effects on specific failure types, the study of interrelations among failure types, and the estimation of failure rates for some causes given the removal of certain other failure types. The usual formation of these problems is in terms of conceptual or latent failure times for each failure type. This approach is criticized on the basis of unwarranted assumptions, lack of physical interpretation and identifiability problems. An alternative approach utilizing cause-specific hazard functions for observable quantities, including time-dependent covariates, is proposed. Cause-specific hazard functions are shown to be the basic estimable quantities in the competing risks framework. A method, involving the estimation of parameters that relate time-dependent risk indicators for some causes to cause-specific hazard functions for other causes, is proposed for the study of interrelations among failure types. Further, it is argued that the problem of estimation of failure rates under the removal of certain causes is not well posed until a mechanism for cause removal is specified. Following such a specification, one will sometimes be in a position to make sensible extrapolations from available data to situations involving cause removal. A clinical program in bone marrow transplantation for leukemia provides a setting for discussion and illustration of each of…
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A lack of empirical data on associations between causes of death has until now prevented a solution from being developed for the problem of competing causes in cause-elimination life tables.
“Although this problem of”
From Gains in life expectancy after elimination of major causes of death: revised estimates taking into account the effect of competing causes. (1999) · cites this paper as [8]
Conventional cause-elimination life table calculations rest on the assumption that those saved from dying because of the eliminated cause have risks of dying from non-eliminated causes equal to the average risks of dying from these causes in the total population.
“The main assumption on which cause-elimination life table calculations rest is, that those who are saved from dying because of the eliminated cause (for example, ischaemic heart disease) have risks of dying from non-eliminated causes that are equal to the average risks of dying from these causes as observed in the total population.”
From Gains in life expectancy after elimination of major causes of death: revised estimates taking into account the effect of competing causes. (1999) · cites this paper as [8]
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Metadata
- Authors
- Prentice, R. L., Kalbfleisch, J. D., Peterson, A. V., Flournoy, N., Farewell, V. T., & Breslow, N. E.
- Venue
- Biometrics
- Publisher
- JSTOR
- Published
- 1978-12
- Volume
- 34
- Issue
- 4
- Pages
- 541
- ISSN
- 0006-341X
- Cited by
- 1,266
- References
- 0
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