Zhang Zhongheng
Department of Emergency Medicine, Sir Run-Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou 310016, China.
Ann Transl Med. 2016 Dec;4(23):461. doi: 10.21037/atm.2016.08.61.
Cox proportional hazards model is a semi-parametric model that leaves its baseline hazard function unspecified. The rationale to use Cox proportional hazards model is that (I) the underlying form of hazard function is stringent and unrealistic, and (II) researchers are only interested in estimation of how the hazard changes with covariate (relative hazard). Cox regression model can be easily fit with coxph() function in survival package. Stratified Cox model may be used for covariate that violates the proportional hazards assumption. The relative importance of covariates in population can be examined with the rankhazard package in R. Hazard ratio curves for continuous covariates can be visualized using smoothHR package. This curve helps to better understand the effects that each continuous covariate has on the outcome. Population attributable fraction is a classic quantity in epidemiology to evaluate the impact of risk factor on the occurrence of event in the population. In survival analysis, the adjusted/unadjusted attributable fraction can be plotted against survival time to obtain attributable fraction function.
Cox比例风险模型是一种半参数模型,其基线风险函数未明确指定。使用Cox比例风险模型的理由是:(I)风险函数的潜在形式严格且不现实,(II)研究人员仅对估计风险如何随协变量变化(相对风险)感兴趣。Cox回归模型可以很容易地用生存包中的coxph()函数拟合。分层Cox模型可用于违反比例风险假设的协变量。可以使用R中的rankhazard包检查协变量在总体中的相对重要性。连续协变量的风险比曲线可以使用smoothHR包进行可视化。这条曲线有助于更好地理解每个连续协变量对结果的影响。人群归因分数是流行病学中评估风险因素对人群中事件发生影响的经典指标。在生存分析中,可以将调整/未调整的归因分数与生存时间作图,以获得归因分数函数。