title: Modeling restricted mean survival time under general censoring mechanisms.
abstract: Restricted mean survival time (RMST) is often of great clinical interest in practice. Several existing methods involve explicitly projecting out patient-specific survival curves using parameters estimated through Cox regression. However, it would often be preferable to directly model the restricted mean for convenience and to yield more directly interpretable covariate effects. We propose generalized estimating equation methods to model RMST as a function of baseline covariates. The proposed methods avoid potentially problematic distributional assumptions pertaining to restricted survival time. Unlike existing methods, we allow censoring to depend on both baseline and time-dependent factors. Large sample properties of the proposed estimators are derived and simulation studies are conducted to assess their finite sample performance. We apply the proposed methods to model RMST in the absence of liver transplantation among end-stage liver disease patients. This analysis requires accommodation for dependent censoring since pre-transplant mortality is dependently censored by the receipt of a liver transplant.
authors.affiliation: Department of Biostatistics, University of Michigan, 1415 Washington Hts., Ann Arbor, MI, 48109-2029, USA.
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Biostatistics, University of Michigan, 1415 Washington Hts., Ann Arbor, MI, 48109-2029, USA. deschau@umich.edu.
authors.forename: Douglas E
authors.identifier: 0000-0002-9792-4474
authors.initials: DE
authors.lastname: Schaubel
mesh_terms: D015982:Bias; D003198:Computer Simulation; D058625:End Stage Liver Disease / Q000401:mortality / Q000601:surgery; D006801:Humans; D016014:Linear Models; D016031:Liver Transplantation; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate
keywords: Dependent censoring; Generalized linear model; Inverse weighting; Pre-treatment survival; Restricted mean lifetime; Transplantation