We are starting the Autumn seminars with a talk on the 18th of October at 1pm BST by Professor Hein Putter from Leiden University on the the subject of competing risks focussing on problems with the Fine-Gray model which in some quarters has become the default method of analysis.

Hein will speak online.  As usual this will be a hybrid event and you may attend in-person.  Or online using MS Teams. Joining instructions will be sent closer to the time.

Speaker:  Prof. Hein Putter, Leiden University, The Netherlands.

Title:  Fine-Gray subdistribution hazard models to simultaneously estimate the absolute risk of different event types: Cumulative total failure probability may exceed 1

Abstract
he Fine-Gray subdistribution hazard model has become the default methodto estimate the incidence of outcomes over time in the presence of competing risks. This model is attractive because it directly relates covariates to the cumulative incidence function (CIF) of the event of interest. An alternative is to combine the different cause-specific hazard functions to obtain the different CIFs. A limitation of the subdistribution hazard approach is that the sum of the cause-specific CIFs can exceed 1 (100%) for some covariate patterns. Using data on 9479 patients hospitalized with acute myocardial infarction, we estimated the cumulative incidence of both cardiovascular death and non-cardiovascular death for each patient. We found that when using subdistribution hazard models, approximately 5% of subjects had an estimated risk of 5-year all-cause death (obtained by combining the two cause-specific CIFs obtained from subdistribution hazard models) that exceeded 1. This phenomenon was avoided by using the two cause-specific hazard models. We provide a proof that the sum of predictions exceeds 1 is a fundamental problem with the Fine-Gray subdistribution hazard model. Care should be taken when using the Fine-Gray subdistribution hazard model in situations with wide risk distributions or a high cumulative incidence, and if one is interested in the risk of failure from each of the different event types.

All Fellows and non-Fellows welcome!

For in-person attendance, the hybrid room is Room 006B (3rd Floor) in the Peter Froggatt Centre (off the main quadrangle) in Queen's University Belfast, Northern Ireland, U.K.  Campus map is here:


Gilbert MacKenzie
Meetings Secretary
RSSNI

Professor Hein Putter, Leiden University, Netherlands.

Gilbert MacKenzie
Meetings Secretary
RSSNI
gilbert.mackenzie.cbs@gmail.com