评估灵活的参数相对生存方法,以强制执行长期约束,在推断全因生存时
Sangyu Lee1, Paul C Lambert2, Michael J Sweeting3
1Biostatistics Research Group, Department of Population Health Sciences, University of Leicester, Leicester, England, UK.
概括
灵活的参数相对存活模型提供了超越试验后续的改善终身益处估计. 在长期过度死亡率上应用约束,包括治愈模型,导致更合理的生存推断.
科学领域:
- 生物统计学 生物统计学
- 卫生经济学 卫生经济学
- 流行病学 流行病学
背景情况:
- 参数模型是评估试验持续时间以外的干预终身益处的标准.
- 最近的指导方针主张灵活的生存模型和外部数据用于推断.
- 灵活的参数相对存活率建模整合了这些建议.
研究的目的:
- 引入和对比方法来限制长期疾病相关死亡率.
- 评估不同推断方法的含义.
- 将治愈模型和趋同与持续过度死亡率进行比较.
主要方法:
- 描述灵活的参数相对生存模型.
- 引入限制长期过度死亡率的选择.
- 在各种场景下比较使用模拟数据的方法.
主要成果:
- 所有方法在随访期内都显示出相似的生存率.
- 根据长期过度死亡率假设,对全因生存率的推断有所不同.
- 限制不同时间点的过度死亡率提供了灵活性.
结论:
- 来自约束的明确假设可以产生更合理的生存推断.
- 建议将一般人口死亡率纳入模型构建.
- 建议在健康技术评估 (HTA) 中更广泛地采用生存外推.
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