敏感性分析，用于估计限制平均生存时间差异时的混淆
Sensitivity analysis for unmeasured confounding in estimating the difference in restricted mean survival time
影响因子:1.90000
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
摘要
在生存分析中，越来越多地将限制平均生存时间的差异用作危害比率的替代措施。尽管已经开发了一些统计方法来估计观察性研究中测量混杂因素的限制平均生存时间的差异，但很少评估未衡量的混杂对估计值的影响。我们开发了一种新颖的敏感性分析，以估计限制的平均生存时间差异相对于未衡量的混杂。在将敏感性分析问题提出为优化问题之后，我们解释了如何有效地获得限制的平均生存时间差异的敏感性范围，并使用百分位数Bootstrap置信区间评估其不确定性。为一些重要的生存环境提供了分析结果。仿真研究表明，所提出的方法在各种环境中都表现良好。我们通过分析德国乳腺癌研究小组研究的数据来说明提出的敏感性分析方法。
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.