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marc1
Level III

Risk adjustment for comorbidities for analysis of survival ?

I compared and analyzed two different patient populations (Virus infection Type 1 and Virus infection Type 2) with one specific treatment in regards to outcome.

 

Kaplan Meier among those groups did not show any difference - which is good - so can make the statement that the unadjusted survival among both groups is the same.

 

However, it seems like one group (eg Virus infection Type 1) is being "sicker" by going into the disease process, by either being older (as a continuous variable) or having more , or other comorbidities than the population Virus infection Type 2. I identified those differences in the pre-existing population by univariate analysis (logistic regression and chi-square depending on).

 

I want to adjust a priori before I do Kaplan Meier analysis to see if this population (Virus Type infection 1) if I adjusted for those risk factors this patient has actually a relative survival benefit ? Or in other words - I want to risk adjust for eg advanced age, and come to the conclusion - as has been shown that the survival is the same ?!

 

Thanks a lot, very timely and important analysis. Marc

   

3 REPLIES 3
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Byron_JMP
Staff

Re: Risk adjustment for comorbidities for analysis of survival ?

It almost sounds like you're interested in doing a non-parametric hazard analysis, so that you can see the effect of each of the covariates?>

JMP Systems Engineer, Pharm and BioPharm Sciences
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marc1
Level III

Re: Risk adjustment for comorbidities for analysis of survival ?

Something like described in this methods - please kindly see attached.

 

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Re: Risk adjustment for comorbidities for analysis of survival ?

@Byron_JMP is giving you good advice, but I ask, why do you need to adjust first? Can't you use a model (e.g., proportional hazard) and include the covariates as fixed effects?

 

The Kaplan-Meier estimate is always valid but mostly provides simple comparisons (i.e., group tests).

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