The analysis of competing events like cause-specific mortality—beware of the Kaplan-Meier method

Kaplan-Meier analysis is a popular method used for analysing time-to-event data. In case of competing event analyses such as that of cardiovascular and non-cardiovascular mortality, however, the Kaplan-Meier method profoundly overestimates the cumulative mortality probabilities for each of the separ...

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Bibliographic Details
Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2011-01, Vol.26 (1), p.56-61
Main Authors: VERDUIJN, Marion, GROOTENDORST, Diana C, DEKKER, Friedo W, JAGER, Kitty J, LE CESSIE, Saskia
Format: Article
Language:English
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cardiovascular Diseases - mortality
Cause of Death
Clinical Trials as Topic
Emergency and intensive care: renal failure. Dialysis management
Humans
Intensive care medicine
Kaplan-Meier Estimate
Medical sciences
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Survival Rate
Tubulopathies
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Summary:Kaplan-Meier analysis is a popular method used for analysing time-to-event data. In case of competing event analyses such as that of cardiovascular and non-cardiovascular mortality, however, the Kaplan-Meier method profoundly overestimates the cumulative mortality probabilities for each of the separate causes of death. This article provides an introduction to the problem of competing events in Kaplan-Meier analysis. It explains cumulative incidence competing risk analysis and demonstrates on a cohort of elderly dialysis patients that, in contrast to the Kaplan-Meier method, application of this method yields unbiased estimates of the cumulative probabilities for cause-specific mortality.
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/gfq661