Estimating a population cumulative incidence under calendar time trends.
BMC Med Res Methodol
; 17(1): 7, 2017 01 11.
Article
em En
| MEDLINE
| ID: mdl-28077076
ABSTRACT
BACKGROUND:
The risk of a disease or psychiatric disorder is frequently measured by the age-specific cumulative incidence. Cumulative incidence estimates are often derived in cohort studies with individuals recruited over calendar time and with the end of follow-up governed by a specific date. It is common practice to apply the Kaplan-Meier or Aalen-Johansen estimator to the total sample and report either the estimated cumulative incidence curve or just a single point on the curve as a description of the disease risk.METHODS:
We argue that, whenever the disease or disorder of interest is influenced by calendar time trends, the total sample Kaplan-Meier and Aalen-Johansen estimators do not provide useful estimates of the general risk in the target population. We present some alternatives to this type of analysis.RESULTS:
We show how a proportional hazards model may be used to extrapolate disease risk estimates if proportionality is a reasonable assumption. If not reasonable, we instead advocate that a more useful description of the disease risk lies in the age-specific cumulative incidence curves across strata given by time of entry or perhaps just the end of follow-up estimates across all strata. Finally, we argue that a weighted average of these end of follow-up estimates may be a useful summary measure of the disease risk within the study period.CONCLUSIONS:
Time trends in a disease risk will render total sample estimators less useful in observational studies with staggered entry and administrative censoring. An analysis based on proportional hazards or a stratified analysis may be better alternatives.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Algoritmos
/
Medição de Risco
/
Transtornos Mentais
/
Modelos Teóricos
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
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Incidence_studies
/
Observational_studies
/
Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
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Middle aged
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article