Kim J S, Broste S K
Pacing Clin Electrophysiol. 1986 Nov;9(6 Pt 2):1265-70. doi: 10.1111/j.1540-8159.1986.tb06706.x.
The actuarial life-table method is often used by pacemaker manufacturers and the pacing research community to describe pacemaker and lead performance. Most life-table methods allow for differing lengths of follow-up but assume that all devices were followed from implant. Occasionally, however, devices come under follow-up observation sometime after implant. This presentation describes an extension of the actuarial method to accommodate these kinds of data. The specific example to be considered involves follow-up data collected by CardioCare, a commercial cardiac monitoring service, on the performance of Medtronic polyurethane leads. Patients subscribe to this service, generally at some time after actual device implant. Results showed that of 12,112 patients with Models 4002, 6971, and 6972 leads who were followed by CardioCare, only 85 were followed from implant. If one were to exclude patients not followed since implant, more than 99% of the data would be lost. Using the modified approach with allowance for postimplant, entry resulted in an estimated three-year cumulative survival probability for these leads of 95.7%. Treating all patients as if they were followed since implant, the probability would be 96.9%, an optimistic and biased estimate.
精算寿命表法常被起搏器制造商和起搏研究界用于描述起搏器和导线的性能。大多数寿命表法允许随访时间长度不同，但假定所有设备从植入起就开始随访。然而，偶尔会有设备在植入一段时间后才开始接受随访观察。本报告描述了精算方法的一种扩展，以适应这类数据。要考虑的具体例子涉及由商业心脏监测服务机构CardioCare收集的关于美敦力聚氨酯导线性能的随访数据。患者通常在实际设备植入后的某个时间订阅这项服务。结果显示，在CardioCare随访的12112名使用4002型、6971型和6972型导线的患者中，只有85名从植入起就开始随访。如果排除植入后未随访的患者，超过99%的数据将丢失。使用允许植入后进入的改良方法，得出这些导线的三年累积生存概率估计为95.7%。若将所有患者都视为从植入起就开始随访，概率将为96.9%，这是一个乐观且有偏差的估计。
