Section of Biostatistics, Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, 1014 Copenhagen, Denmark.
Department of Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Biostatistics. 2019 Apr 1;20(2):347-357. doi: 10.1093/biostatistics/kxy006.
We show that the widely used concordance index for time to event outcome is not proper when interest is in predicting a $t$-year risk of an event, for example 10-year mortality. In the situation with a fixed prediction horizon, the concordance index can be higher for a misspecified model than for a correctly specified model. Impropriety happens because the concordance index assesses the order of the event times and not the order of the event status at the prediction horizon. The time-dependent area under the receiver operating characteristic curve does not have this problem and is proper in this context.
我们表明,当关注的是预测事件的 $t$ 年风险时,例如 10 年死亡率,广泛使用的用于时间事件结果的一致性指数并不合适。在具有固定预测期限的情况下,对于指定不当的模型,一致性指数可以高于正确指定的模型。不合适是因为一致性指数评估事件时间的顺序,而不是预测期限内事件状态的顺序。时间依赖性接收器操作特性曲线下的面积没有这个问题,在这种情况下是合适的。