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When to Censor?

Catherine R Lesko1, Jessie K Edwards2, Stephen R Cole2

  • 1Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.

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This summary is machine-generated.

Handling loss to follow-up in time-to-event analyses is crucial. Person-time should be censored at the loss to follow-up criterion if the event is captured externally, but at the last study encounter if the event requires in-person measurement.

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Area of Science:

  • Biostatistics
  • Epidemiology
  • Clinical Trials

Background:

  • Loss to follow-up is a common challenge in time-to-event analyses, impacting data integrity.
  • Current methods for handling person-time after the last study encounter lack consensus, potentially introducing bias.

Purpose of the Study:

  • To clarify appropriate censoring strategies for person-time in time-to-event analyses with loss to follow-up.
  • To provide guidance on handling data between the last study encounter and the defined loss to follow-up point.

Main Methods:

  • The study employed simulation and a case example to evaluate different censoring schemes.
  • Analysis focused on time-to-event data where events are captured either externally or during study encounters.

Main Results:

  • When events are captured outside study encounters (e.g., registries), censoring should occur at the loss to follow-up criterion.
  • When events must be measured during study encounters (e.g., biomarkers), censoring should occur at the last study encounter.

Conclusions:

  • The choice of censoring strategy critically depends on how the event of interest is ascertained.
  • Inappropriate censoring can lead to significant and potentially uncorrectable bias in time-to-event analyses.