Competing Risks and Multi-State Models [BST03]

Course highlights

EC points

0.9

Start date

10-02-2020

End date

12-02-2020

Course days

Monday to Wednesday

Faculty

Prof.dr. Hein Putter

Level

Intermediate

Prerequisites

Participants should have working knowledge of survival analysis and not feel uncomfortable with mathematical formulas. Knowledge of R is highly recommended.

Disciplines

  • Biostatistics

Application

How to apply

Detailed information about this course:

Description

Competing risks and multi-state models play an increasingly important role in the analysis of time to event data. Regarding competing risks, there is a lot of confusion regarding the proper analysis. The most important reason for the confusion is conceptual: which quantities can be estimated and what do they represent. Once the concepts are understood and the proper type of analysis has been chosen, most analyses are straightforward and can be performed with standard software for survival analysis. For multi-state models with exactly observed transition times, estimation is reasonably straightforward and the real challenge is in (dynamic) prediction.

The overarching goal of the course is to provide a solid introduction to these topics and thereby increase the analytical validity in this field.

In the first part of the course we cover competing risks analysis: what are competing risks and when do we need to take them into account; the independence assumption; cause-specific cumulative incidence; cause-specific hazard and subdistribution hazard; competing risks as a multi-state model. We will also cover regression models on both cause-specific and subdistribution hazard (Fine-Gray model) and discuss the difference in interpretation. We show how analyses can be performed with standard software. In the second part of the course, the extension to multi-state models is discussed. The course will cover topics including transition intensities and transition probabilities, nonparametric estimation and regression models, as well as methods to obtain predictions of future events, given the event history and clinical characteristics of a patient. With right censored and/or left truncated data, we show that it is possible to perform many types of analyses using standard software, using the same techniques as in multi-state representation of the competing risks model.

Objectives

After successfully completing the course, the student will be able to:

  • Describe the quantities that can be estimated in a competing risks framework, how they are interpreted, and the assumptions that must be made.
  • Understand the relationship between the cause-specific hazard and cumulative incidence and describe why it is no longer one-to-one in a competing risks framework.
  • Propose a suitable statistical model for assessing a specific research hypothesis in a competing risks situation, fit the model using standard statistical software, and interpret the results.
  • Recognise when a multi-state model is appropriate, fit a multi-state model using standard statistical software, evaluate the fit of the model, and interpret the results.

Assessment

Assignment(s)


Reduction on fees

PLEASE NOTE THIS DOES NOT APPLY TO THE RESEARCH MASTERS (120 EC points)

50% reduction on our fees for participating institutes of NIHES

This 50% reduction is offered to participants formally appointed at the departments or sections participating in NIHES.

University Medical Center Rotterdam/Erasmus University Rotterdam:

  • Department of Epidemiology
  • Department of Public Health
  • Department of Psychiatry, Section of Medical Psychology and Psychotherapy
  • Department of Child and Adolescent Psychiatry/Psychology
  • Department of Medical Informatics
  • Department of General Practice
  • Erasmus School of Health Policy & Management
  • Generation R

50% reduction on our fees for NIHES affiliated partners

This 50% reduction is offered to participants formally appointed at the following NIHES affiliated partners:

University Medical Center Rotterdam/Erasmus University Rotterdam, departments of:

  • Dermatology
  • General Paediatrics
  • Plastic and Reconstructive Surgery
  • Rehabilitation Medicine

Institute of Medical Education Research Rotterdam (iMERR)

Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital

  • Department of Cancer Epidemiology

25% reduction on our fees for partner institutes of NIHES

For participants formally appointed at the following departments, institutes:

  • Departments of Erasmus MC (except the departments mentioned above)
  • Addiction Research Institute (IVO)
  • Integraal Kankercentrum Zuid (IKZ)
  • Pallas Health Research and Consultancy
  • Municipal Health Service Amsterdam (GGD Amsterdam)
  • Municipal Health Service Rotterdam (GGD Rotterdam)
  • Havenpolikliniek
  • Admiraal De Ruyter Ziekenhuis

25% reduction for all (international) PhD students
Please state your supervisor/promotor’s name and email address on the application form (remarks field).

25% reduction on our course fees (maximum 3 EC points per academic year) for all NIHES alumni
Please state that you are a NIHES alumnus/alumna and the academic year you graduated (remarks field). Please note that the reduction on fees for alumni does not apply to the Erasmus Summer Programme.