未测量混杂因素对限制平均生存时间差异估算的敏感性分析
Sensitivity analysis for unmeasured confounding in estimating the difference in restricted mean survival time
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影响因子:1.9
分区:数学3区 / 数学与计算生物学2区 统计学与概率论2区 卫生保健与服务3区 医学：信息4区
发表日期:2024 Nov
作者:
Seungjae Lee, Ji Hoon Park, Woojoo Lee
DOI:
10.1177/09622802241280782
摘要
限制平均生存时间差异作为生存分析中风险比的替代指标，近年来被广泛应用。虽已有一些统计方法用于调整观察性研究中测量到的混杂因素的限制平均生存时间差异估算，但对未测量混杂因素影响的评估较少。我们提出一种新的敏感性分析方法，用于评估未测量混杂对限制平均生存时间差异的影响。在将敏感性分析问题转化为优化问题后，阐述了如何高效获取限制平均生存时间差异的敏感性范围，并利用百分位自助法（bootstrap）置信区间评估其不确定性。对于一些重要的生存场景，提供了解析结果。模拟研究显示，该方法在不同模拟条件下表现良好。我们通过分析德国乳腺癌研究组的实际数据，示范了该敏感性分析方法的应用。
Abstract
The difference in restricted mean survival time has been increasingly used as an alternative measure to the hazard ratio in survival analysis. Although some statistical methods have been developed for estimating the difference in restricted mean survival time adjusted for measured confounders in observational studies, the impact of unmeasured confounding on the estimate has rarely been assessed. We develop a novel sensitivity analysis for the estimate of the difference in restricted mean survival time with respect to unmeasured confounding. After formulating the sensitivity analysis problem as an optimization problem, we explain how to obtain the sensitivity range of the difference in restricted mean survival time efficiently and assess its uncertainty using the percentile bootstrap confidence interval. Analytic results are provided for some important survival settings. Simulation studies show that the proposed methods perform well in various settings. We illustrate the proposed sensitivity analysis method by analyzing data from the German Breast Cancer Study Group study.