Regression models for the restricted residual mean life for right-censored and left-truncated data

Stat Med. 2017 May 20;36(11):1803-1822. doi: 10.1002/sim.7222. Epub 2017 Jan 20.

Abstract

The hazard ratios resulting from a Cox's regression hazards model are hard to interpret and to be converted into prolonged survival time. As the main goal is often to study survival functions, there is increasing interest in summary measures based on the survival function that are easier to interpret than the hazard ratio; the residual mean time is an important example of those measures. However, because of the presence of right censoring, the tail of the survival distribution is often difficult to estimate correctly. Therefore, we consider the restricted residual mean time, which represents a partial area under the survival function, given any time horizon τ, and is interpreted as the residual life expectancy up to τ of a subject surviving up to time t. We present a class of regression models for this measure, based on weighted estimating equations and inverse probability of censoring weighted estimators to model potential right censoring. Furthermore, we show how to extend the models and the estimators to deal with delayed entries. We demonstrate that the restricted residual mean life estimator is equivalent to integrals of Kaplan-Meier estimates in the case of simple factor variables. Estimation performance is investigated by simulation studies. Using real data from Danish Monitoring Cardiovascular Risk Factor Surveys, we illustrate an application to additive regression models and discuss the general assumption of right censoring and left truncation being dependent on covariates. Copyright © 2017 John Wiley & Sons, Ltd.

Keywords: inverse probability of censoring weighting; left truncation; residual mean life; survival regression models.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / mortality
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Models, Statistical
  • Probability
  • Proportional Hazards Models*
  • Regression Analysis
  • Risk Factors
  • Survival Analysis*