Stratified Restricted Mean Survival Time Model for Marginal Causal Effect in Observational Survival Data.

ABSTRACT: Time to event outcomes is commonly encountered in epidemiologic research. Multiple papers have discussed the inadequacy of using the hazard ratio as a causal effect measure due to its noncollapsibility and the time-varying nature. In this paper, we further clarified that the hazard ratio might be used as a conditional causal effect measure, but it is generally not a valid marginal effect measure, even under randomized design. We proposed to use the restricted mean survival time (RMST) difference as a causal effect measure, since it essentially measures the mean difference over a specified time horizon and has a simple interpretation as the area under survival curves. For observational studies, propensity score adjustment can be implemented with RMST estimation to remove observed confoundin

SUBMITTER: Ni A 

PROVIDER: S-EPMC8629851 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature