ArticleAmerican journal of epidemiology2022
Implementation of an Alternative Method for Assessing Competing Risks: Restricted Mean Time Lost.
Article in American journal of epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Recombinant shingles vaccination and the risk of cardiovascular events.Nature medicine · 2026Article
- Lower risk of dementia with AS01-adjuvanted vaccination against shingles and respiratory syncytial virus infections.NPJ vaccines · 2025Article
- Multi-group global tests for restricted mean survival time and restricted mean time lost: a variable transformation approach.BMC medical research methodology · 2025Article
- Longer disease progression milestone-free time in people with amyotrophic lateral sclerosis treated versus not treated with intravenous edaravone: results from an administrative claims analysis.Journal of comparative effectiveness research · 2025Observational
- Using Restricted Mean Time Lost to Evaluate the Prognostic Effects on Locally Advanced Breast Cancer Considering Competing Risks.Clinical epidemiology · 2025Article
- Evaluating US Multiple Listing Practices in Lung Transplantation: Unveiling Hidden Disparities.Chest · 2024Article
- The recombinant shingles vaccine is associated with lower risk of dementia.Nature medicine · 2024Article
- Assessing treatment effects with adjusted restricted mean time lost in observational competing risks data.BMC medical research methodology · 2024Article
- Time-varying effect in older patients with early-stage breast cancer: a model considering the competing risks based on a time scale.Frontiers in oncology · 2024Article
- Restricted mean survival time regression model with time-dependent covariates.Statistics in medicine · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In clinical and epidemiologic studies, hazard ratios are often applied to compare treatment effects between 2 groups for survival data. For competing-risks data, the corresponding quantities of interest are cause-specific hazard ratios and subdistribution hazard ratios. However, they both have some limitations related to model assumptions and clinical interpretation. Therefore, we recommend restricted mean time lost (RMTL) as an alternative measure that is easy to interpret in a competing-risks framework. Based on the difference in RMTL (RMTLd), we propose a new estimator, hypothetical test, and sample-size formula. Simulation results show that estimation of the RMTLd is accurate and that the RMTLd test has robust statistical performance (both type I error and statistical power). The results of 3 example analyses also verify the performance of the RMTLd test. From the perspectives of clinical interpretation, application conditions, and statistical performance, we recommend that the RMTLd be reported along with the hazard ratio in analyses of competing-risks data and that the RMTLd even be regarded as the primary outcome when the proportional hazards assumption fails.
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