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05.11A · Cours 11 — Analyse de survie

Course 11 — Survival analysis

Course and questions · 58 pages

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1Survival Analysis
Review: Prospective Studies
2Risk and Prevalence Definitions3Association Measures by Study Type4Incidence Rate vs Risk5Glossary: Prevalence, Risk, Incidence Rate
6Learning Objectives7Survival Analysis Definition and Uses
Survival Data
8Follow-up Duration and Events9Aligning to Time Zero
Risk Over Time
10Cumulative Risk Counting
Survival Curve
11Definition: Survival Probability12Shape Rules: Starts at 1, Non-increasing13Different Curve Shapes and Meaning14Estimated Curve: Risk at Event Times15Estimated Curve: Converting Risk to Survival16Estimated Curve: Stepwise Construction17Estimated Curve: Staircase Shape Summary18Reading Survival Probabilities: Glioblastoma Example19Step Heights and Multiple Events
Median Survival Time
20Definition and Curve Reading21Undefined Median: MACE-Free Survival Example
Constant Hazard Curve
22Exponential Decay with 40% Monthly Risk23Constant 16% Monthly Death Risk Example
Survival Curve Summary
24Survival Curve Summary25Visual Metaphor: Staircase Shape
26Risk vs Survival Curve vs Incidence Rate
Censored Data
27Definition of Censoring28Censoring at Study End29Censoring from Loss to Follow-up
Kaplan-Meier Method
30Principle: Interval-Based Estimation31Calculation Setup: 10 Patients32Interval 0–1 Month: No Event33At 1 Month: First Event, S = 0.9034Interval 1–2 Months: No Event, Flat35At 2 Months: Censoring, No Step36Interval 2–3 Months: 8 at Risk, No Event37At 3 Months: Event + Censoring38Conditional Probability: S(3) = 0.90 × 7/839Interval 3–4 Months: No Event, Flat at 0.7940At 4 Months: Event, S = 0.79 × 5/6 = 0.6641Independence Assumption for Censoring42Kaplan-Meier Summary
Comparing Survival Curves
43Objectives: Exposure and Trial Comparisons
Log-Rank Test
44Principle and Hypotheses45ECOG Group Definitions for Comparison46ECOG Survival Curves: p < 0.000147Median Survival: ECOG 0-2 (8 mo) vs 3-4 (4 mo)48Interpreting p-Value and Rejecting H049Warning: Group Curves ≠ Individual Order
Clinical Examples
50Lung Health Study: Trial Design51Lung Health Study: Survival Curves
Hazard Ratio
52Association Measures: Introducing HR53Glioblastoma HR = 2.18 (ECOG 3-4 vs 0-2)54Lung Health Study: HR = 1.18 for Usual Care55Risk Plot Instead of Survival Plot56Cox Regression Model
57Key Messages58Next Session Preview