Search

Text Color

Margin Size

Font Type

Enable Dyslexic Font

20.9: Survival analysis

Last updated

Sep 4, 2024
Save as PDF
- 20.8: Diversity indexes
- 20.10: Growth equations and dose response calculations

$\newcommand{\vecs}[1]{\overset { \scriptstyle \rightharpoonup} {\mathbf{#1}} }$

$\newcommand{\vecd}[1]{\overset{-\!-\!\rightharpoonup}{\vphantom{a}\smash {#1}}}$

$\newcommand{\id}{\mathrm{id}}$ $\newcommand{\Span}{\mathrm{span}}$

( \newcommand{\kernel}{\mathrm{null}\,}\) $\newcommand{\range}{\mathrm{range}\,}$

$\newcommand{\RealPart}{\mathrm{Re}}$ $\newcommand{\ImaginaryPart}{\mathrm{Im}}$

$\newcommand{\Argument}{\mathrm{Arg}}$ $\newcommand{\norm}[1]{\| #1 \|}$

$\newcommand{\inner}[2]{\langle #1, #2 \rangle}$

$\newcommand{\Span}{\mathrm{span}}$

$\newcommand{\id}{\mathrm{id}}$

$\newcommand{\Span}{\mathrm{span}}$

$\newcommand{\kernel}{\mathrm{null}\,}$

$\newcommand{\range}{\mathrm{range}\,}$

$\newcommand{\RealPart}{\mathrm{Re}}$

$\newcommand{\ImaginaryPart}{\mathrm{Im}}$

$\newcommand{\Argument}{\mathrm{Arg}}$

$\newcommand{\norm}[1]{\| #1 \|}$

$\newcommand{\inner}[2]{\langle #1, #2 \rangle}$

$\newcommand{\Span}{\mathrm{span}}$ $\newcommand{\AA}{\unicode[.8,0]{x212B}}$

$\newcommand{\vectorA}[1]{\vec{#1}} % arrow$

$\newcommand{\vectorAt}[1]{\vec{\text{#1}}} % arrow$

$\newcommand{\vectorB}[1]{\overset { \scriptstyle \rightharpoonup} {\mathbf{#1}} }$

$\newcommand{\vectorC}[1]{\textbf{#1}}$

$\newcommand{\vectorD}[1]{\overrightarrow{#1}}$

$\newcommand{\vectorDt}[1]{\overrightarrow{\text{#1}}}$

$\newcommand{\vectE}[1]{\overset{-\!-\!\rightharpoonup}{\vphantom{a}\smash{\mathbf {#1}}}}$

$\newcommand{\vecs}[1]{\overset { \scriptstyle \rightharpoonup} {\mathbf{#1}} }$

$\newcommand{\vecd}[1]{\overset{-\!-\!\rightharpoonup}{\vphantom{a}\smash {#1}}}$

$\newcommand{\avec}{\mathbf a}$

$\newcommand{\bvec}{\mathbf b}$

$\newcommand{\cvec}{\mathbf c}$

$\newcommand{\dvec}{\mathbf d}$

$\newcommand{\dtil}{\widetilde{\mathbf d}}$

$\newcommand{\evec}{\mathbf e}$

$\newcommand{\fvec}{\mathbf f}$

$\newcommand{\nvec}{\mathbf n}$

$\newcommand{\pvec}{\mathbf p}$

$\newcommand{\qvec}{\mathbf q}$

$\newcommand{\svec}{\mathbf s}$

$\newcommand{\tvec}{\mathbf t}$

$\newcommand{\uvec}{\mathbf u}$

$\newcommand{\vvec}{\mathbf v}$

$\newcommand{\wvec}{\mathbf w}$

$\newcommand{\xvec}{\mathbf x}$

$\newcommand{\yvec}{\mathbf y}$

$\newcommand{\zvec}{\mathbf z}$

$\newcommand{\rvec}{\mathbf r}$

$\newcommand{\mvec}{\mathbf m}$

$\newcommand{\zerovec}{\mathbf 0}$

$\newcommand{\onevec}{\mathbf 1}$

$\newcommand{\real}{\mathbb R}$

$\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}$

$\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}$

$\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}$

$\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}$

$\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}$

$\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}$

$\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}$

$\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}$

$\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}$

$\newcommand{\laspan}[1]{\text{Span}\{#1\}}$

$\newcommand{\bcal}{\cal B}$

$\newcommand{\ccal}{\cal C}$

$\newcommand{\scal}{\cal S}$

$\newcommand{\wcal}{\cal W}$

$\newcommand{\ecal}{\cal E}$

$\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}$

$\newcommand{\gray}[1]{\color{gray}{#1}}$

$\newcommand{\lgray}[1]{\color{lightgray}{#1}}$

$\newcommand{\rank}{\operatorname{rank}}$

$\newcommand{\row}{\text{Row}}$

$\newcommand{\col}{\text{Col}}$

$\renewcommand{\row}{\text{Row}}$

$\newcommand{\nul}{\text{Nul}}$

$\newcommand{\var}{\text{Var}}$

$\newcommand{\corr}{\text{corr}}$

$\newcommand{\len}[1]{\left|#1\right|}$

$\newcommand{\bbar}{\overline{\bvec}}$

$\newcommand{\bhat}{\widehat{\bvec}}$

$\newcommand{\bperp}{\bvec^\perp}$

$\newcommand{\xhat}{\widehat{\xvec}}$

$\newcommand{\vhat}{\widehat{\vvec}}$

$\newcommand{\uhat}{\widehat{\uvec}}$

$\newcommand{\what}{\widehat{\wvec}}$

$\newcommand{\Sighat}{\widehat{\Sigma}}$

$\newcommand{\lt}{<}$

$\newcommand{\gt}{>}$

$\newcommand{\amp}{&}$

$\definecolor{fillinmathshade}{gray}{0.9}$

[Page rough draft]

Introduction

As the name suggests, survival analysis is a branch of statistics used to account for death of organisms, or more generally, failure in a system. In general, this kind of analysis models time to event, where event would be death or failure. The basics of the method is defined by the survival function

$S_{t} = Pr (T < t) \nonumber$

where $t$ is time, $T$ is a variable that represents time of death or other end point, and $Pr$ is probability of an event occurring later than at time $t$ .

Excellent resources available, series of articles in volume 89 of British Journal of Cancer: Clark et al (2003a), Bradburn et al (2003a), Bradburn et al (2003b), and Clark et al (2003b).

Hazard function

Defined as the event rate at time $t$ based on survival for time times equal to or greater than $t$ .

Censoring

Censoring is a a missing data problem typical of survival analysis. Distinguish right-censored and left-censored.

Kaplan-Meier plot

Kaplan-Meier (KM) estimator of survival function. Other survival function estimators Fleming-Harrington. The KM estimator, $\hat{S}_{t}$ is $\hat{S}(t) = \prod_{i: t_{i} \leq t} \left(1 - \frac{d_{i}}{n_{i}}\right) \nonumber$

where $d_{i}$ is the number of events that occurred at time $t_{i}$ , $n_{i}$ is the number of individuals known to have survived or not been censored. Because it’s an estimate, a statistic, we need an estimate of the error variance. Several options, the default in R is the Greenwood estimator. $var \left(\hat{S}(t)\right) = \hat{S}(t)^{2} \sum_{i: t_{i} \leq t} \frac{d_{i}}{n_{i} \left(n_{i} - d_{i}\right)} \nonumber$

The KM plot, censoring times noted with plus.

R code

Download and install the RcmdrPlugin.survival package.

Example

data(heart, package="survival")
attach(heart)
#Get help with the data set
help("heart", package="survival")

head(heart)

 start stop event        age      year surgery transplant id
1    0   50     1 -17.155373 0.1232033       0          0  1
2    0    6     1   3.835729 0.2546201       0          0  2
3    0    1     0   6.297057 0.2655715       0          0  3
4    1   16     1   6.297057 0.2655715       0          1  3
5    0   36     0  -7.737166 0.4900753       0          0  4
6   36   39     1  -7.737166 0.4900753       0          1  4

Run basic survival analysis. After installing the RcmdrPlugin.survival, from Rcmdr select estimate survival function.

Statistics dropdown menu in R Commander, with the Survival analysis submenu opened to show the option for Estimate survival function. — Figure $\PageIndex{1}$ : Screenshot of menu call for survival analysis in Rcmdr.

Get survival estimator and KM plot (Figure $\PageIndex{2}$ )

R output:

.Survfit <- survfit(Surv(start, event) ~ 1, conf.type="log", conf.int=0.95, 
Rcmdr+ type="kaplan-meier", error="greenwood", data=heart)

 .Survfit
Call: survfit(formula = Surv(start, event) ~ 1, data = heart, error = "greenwood", 
conf.type = "log", conf.int = 0.95, type = "kaplan-meier")

n events median 0.95LCL 0.95UCL 
172 75 26 17 37

plot(.Survfit, mark.time=TRUE) 

quantile(.Survfit, quantiles=c(.25,.5,.75))
$quantile
25 50 75 
3 26 67

$lower
25 50 75 
1 17 46

$upper
25 50 75 
12 37 NA

#by default, Rcmdr removes the object
remove(.Survfit)

Kaplan-Meier plot of heart data, showing survival probability vs days. Survival function shown as solid line, with upper and lower confidence intervals shown as dashed lines. — Figure $\PageIndex{2}$ : Kaplan-Meier plot of heart data. Dashed lines are upper and lower confidence intervals about the survival function.

Note:

I modified the plot() code with these additions

ylim = c(0,1), ylab="Survival probability", xlab="Days", lwd=2, col="blue"

the data set includes age and whether or not subjects had heart surgery before transplant. Compare.

Variable surgery is recorded 0,1, so need to create a factor

fSurgery <- as.factor(surgery)

Now, to compare

Rcmdr: Statistics → Survival analysis → Compare survival functions…

R output

Rcmdr> survdiff(Surv(start,event) ~ fSurgery, rho=0, data=heart)
Call:
survdiff(formula = Surv(start, event) ~ fSurgery, data = heart, 
rho = 0)

              N Observed Expected (O-E)^2/E (O-E)^2/V
fSurgery=No 143       66     58.7     0.902      4.56
fSurgery=Yes 29        9     16.3     3.255      4.56

Chisq= 4.6 on 1 degrees of freedom, p= 0.03

Get the KM estimator and make a KM plot

mySurvfit <- survfit(Surv(start, event) ~ surgery, conf.type="log", conf.int=0.95,
type="kaplan-meier", error="greenwood", data=heart)

plot(mySurvfit, mark.time=TRUE, ylim=c(0,1),lwd=2, col=c("blue","red"), xlab="Number of days", ylab="Survival probability")
legend("topright", legend = paste(c("Surgery - No", "Surgery - Yes")), col = c("blue", "red"), pch = 19, bty = "n")

Kaplan-Meier plot of survival functions for heart patients with and without surgery. — Figure $\PageIndex{3}$ : Kaplan-Meier plot of heart patient survival functions with and without surgery.

The comparison plot can be made in Rcmdr by selecting our Surgery factor in Strata setting (Fig. $\PageIndex{4}$ ). Recall that strata refers to subgroups of a population.

Questions

[pending]