Department of Biostatistics, University of Florida, Gainesville, Florida.
Stat Med. 2024 Aug 30;43(19):3563-3577. doi: 10.1002/sim.10142. Epub 2024 Jun 16.
In cancer and other medical studies, time-to-event (eg, death) data are common. One major task to analyze time-to-event (or survival) data is usually to compare two medical interventions (eg, a treatment and a control) regarding their effect on patients' hazard to have the event in concern. In such cases, we need to compare two hazard curves of the two related patient groups. In practice, a medical treatment often has a time-lag effect, that is, the treatment effect can only be observed after a time period since the treatment is applied. In such cases, the two hazard curves would be similar in an initial time period, and the traditional testing procedures, such as the log-rank test, would be ineffective in detecting the treatment effect because the similarity between the two hazard curves in the initial time period would attenuate the difference between the two hazard curves that is reflected in the related testing statistics. In this paper, we suggest a new method for comparing two hazard curves when there is a potential treatment time-lag effect based on a weighted log-rank test with a flexible weighting scheme. The new method is shown to be more effective than some representative existing methods in various cases when a treatment time-lag effect is present.
在癌症和其他医学研究中,事件时间(例如,死亡)数据很常见。分析事件时间(或生存)数据的主要任务之一通常是比较两种医学干预措施(例如,治疗和对照)对患者发生相关事件的风险的影响。在这种情况下,我们需要比较两个相关患者组的两个危险曲线。在实践中,医疗处理通常具有时滞效应,即治疗效果只能在治疗应用后一段时间才能观察到。在这种情况下,两条危险曲线在前一段时间内会相似,传统的检验程序,如对数秩检验,在检测治疗效果时将无效,因为在前一段时间内两条危险曲线之间的相似性会减弱反映在相关检验统计中的两条危险曲线之间的差异。在本文中,我们提出了一种基于加权对数秩检验的新方法,该方法具有灵活的加权方案,用于比较存在潜在治疗时滞效应时的两条危险曲线。当存在治疗时滞效应时,该新方法在各种情况下都比一些有代表性的现有方法更有效。