Survival Analysis

time to event analysis

Debby Syahru Romadlon & Raden Ahmad Dedy M

 Outline

Purposes
Introduction the Concept
• Survival d a t a and c e n s o r i n g
• Functions f o r d e s c r i b i n g survival
• Kaplan-Meier (KM) c u r v e s (review)
• Log- r ank t e s t (review)
• Hazard f u n c t i o n
• P r o p o r t i o n a l hazards model
• Cox model
• The Cox model in SPSS
 Aims
To introduce the concepts, analytical methods,
and applications in survival analysis
 Introduction
Survival analysis is the analysis of time-to-event
data. Such data describe the length of time from
a time origin to an endpoint of interest
 Things that need to be precisely defined

1. “TIME” (with origin)

Time since recruitment into the study
Time since randomization (in a clinical trial)
Time since employment
Time since diagnosis (prognosis studies)
Time since infection (e.g. HIV)
Time since menarche
Calendar time
Age 2. “EVENT” (with date or precise time in
appropriate scale

Death
Disease (diagnostic, start of symptom, relapse)
Remission of diarrhea
Quit smoking
Menopause
 Special features of survival data
Special features:

(1)The survival data are generally not

symmetrically distributed (tend to be
positively skewed)
(2)The survival times are frequently
censored (i.e., when the end-point of
interest has not been observed for that
individual)

Important The actual survival time of an individual, t, is

Assumption independent of any mechanism which causes that
of censored individual’s survival time to be censored at time c,
data: where c < t (i.e., uninformative censoring)
C e n s o r e d o b s e r v a ti o n
Tr u e S ( t )

Have, on the average,

the same experience
after being censored
than those remaining
under observation
(“Uninformative
censoring”, censoring
is not related to risk of
the event)
If losses “die” immediately after
being lost (e.g., because the
more severe cases go to another 8
Key Assumption—Uninformative Censoring

C e n s o r e d o b s e r v a ti o n Tr u e S ( t )

Have, on the average,

the same experience
after being censored
than those remaining
under observation
(“Uninformative
censoring”, censoring
is not related to risk of
the event)
If losses “die” immediately after
being lost (e.g., because the
more severe cases go to another 9
 Special features of survival data

Special features:

(1)The survival data are generally

not symmetrically distributed
(tend to be positively skewed)
(2)The survival times are frequently
censored (i.e., when the end-
point of interest has not been
observed for that individual)

Important The actual survival time of an individual, t, is

Assumptio independent of any mechanism which causes that
n of individual’s survival time to be censored at time c,
censored
data: where c < t (i.e., uninformative censoring) 10