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Competing risks analyses: objectives and approaches

Marcel Wolbers1, Michael T Koller2, Vianda S Stel3

  • 1Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK mwolbers@oucru.org.

European Heart Journal
|April 9, 2014
PubMed

Insights

Competing risks methods are crucial in cardiology studies to analyze multiple disease events. These statistical approaches correctly assess the time to the first event, even when other outcomes may occur first.

Area of Science:

  • Cardiology
  • Biostatistics
  • Survival Analysis

Background:

  • Cardiology research frequently tracks multiple disease outcomes like death or hospitalization.
  • Analyzing time to a specific event is complicated by the possibility of other events occurring first.

Purpose of the Study:

  • To provide a non-technical overview of competing risks concepts.
  • To explain the application of competing risks in descriptive and regression analyses for cardiology studies.

Main Methods:

  • Introduction to the cumulative incidence function for descriptive statistics.
  • Explanation of regression models for cumulative incidence and cause-specific hazard functions.
  • Emphasis on selecting appropriate statistical methods for competing risks scenarios.

Main Results:

  • The cumulative incidence function is presented as a key tool for descriptive analysis.
  • Regression models for cumulative incidence and cause-specific hazards are introduced.
  • The significance of using correct statistical methods when facing competing risks is highlighted.

Conclusions:

  • Appropriate statistical methods are essential when dealing with competing risks in cardiology.
  • Competing risks methods accurately analyze the time to the first event and its type.
  • Understanding competing risks is vital for analyzing composite endpoints in clinical research.

Keywords:
Cause-specific hazard functionCombined endpointsCumulative incidence functionMultiple failure causesSurvival analysis

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