title: Estimating the concordance probability in a survival analysis with a discrete number of risk groups.
abstract: A clinical risk classification system is an important component of a treatment decision algorithm. A measure used to assess the strength of a risk classification system is discrimination, and when the outcome is survival time, the most commonly applied global measure of discrimination is the concordance probability. The concordance probability represents the pairwise probability of lower patient risk given longer survival time. The c-index and the concordance probability estimate have been used to estimate the concordance probability when patient-specific risk scores are continuous. In the current paper, the concordance probability estimate and an inverse probability censoring weighted c-index are modified to account for discrete risk scores. Simulations are generated to assess the finite sample properties of the concordance probability estimate and the weighted c-index. An application of these measures of discriminatory power to a metastatic prostate cancer risk classification system is examined.
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, 10065, USA. hellerg@mskcc.org.
authors.forename: Glenn
authors.initials: G
authors.lastname: Heller
authors.affiliation: Department of Medicine and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, 77030, USA.
authors.forename: Qianxing
authors.initials: Q
authors.lastname: Mo
mesh_terms: D000465:Algorithms; D003198:Computer Simulation; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D015233:Models, Statistical; D011336:Probability; D011471:Prostatic Neoplasms / Q000401:mortality / Q000628:therapy; D012306:Risk; D016019:Survival Analysis
keywords: C-index; Concordance probability estimate; Discrimination; Inverse probability censoring weight; Risk classification