%0 Journal Article %1 Fennema2010 %A Fennema, P %A Lubsen, J %D 2010 %J The Journal of bone and joint surgery. British volume %K Arthroplasty Bias(Epidemiology) DataInterpretation Hip Hip:mortality Hip:statistics&numericaldata HipProsthesis HipProsthesis:standards Humans Incidence Models OutcomeAssessment(HealthCare) OutcomeAssessment(HealthCare):methods ProsthesisDesign ProsthesisDesign:standards ProsthesisFailure Reoperation Reoperation:statistics&numericaldata Replacement Statistical SurvivalAnalysis Theoretical %N 5 %P 701-6 %R 10.1302/0301-620X.92B5.23470 %T Survival analysis in total joint replacement: an alternative method of accounting for the presence of competing risk. %U http://www.ncbi.nlm.nih.gov/pubmed/20436009 %V 92 %X Survival analysis is an important tool for assessing the outcome of total joint replacement. The Kaplan-Meier method is used to estimate the incidence of revision of a prosthesis over time, but does not account appropriately for competing events which preclude revision. In the presence of competing death, this method will lead to statistical bias and the curve will lose its interpretability. A valid comparison of survival results between studies using the method is impossible without accounting for different rates of competing events. An alternative and easily applicable approach, the cumulative incidence of competing risk, is proposed. Using three simulated data sets and realistic data from a cohort of 406 consecutive cementless total hip prostheses, followed up for a minimum of ten years, both approaches were compared and the magnitude of potential bias was highlighted. The Kaplan-Meier method overestimated the incidence of revision by almost 4% (60% relative difference) in the simulations and more than 1% (31.3% relative difference) in the realistic data set. The cumulative incidence of competing risk approach allows for appropriate accounting of competing risk and, as such, offers an improved ability to compare survival results across studies. %@ 0301-620X

@article{Fennema2010, abstract = {Survival analysis is an important tool for assessing the outcome of total joint replacement. The Kaplan-Meier method is used to estimate the incidence of revision of a prosthesis over time, but does not account appropriately for competing events which preclude revision. In the presence of competing death, this method will lead to statistical bias and the curve will lose its interpretability. A valid comparison of survival results between studies using the method is impossible without accounting for different rates of competing events. An alternative and easily applicable approach, the cumulative incidence of competing risk, is proposed. Using three simulated data sets and realistic data from a cohort of 406 consecutive cementless total hip prostheses, followed up for a minimum of ten years, both approaches were compared and the magnitude of potential bias was highlighted. The Kaplan-Meier method overestimated the incidence of revision by almost 4% (60% relative difference) in the simulations and more than 1% (31.3% relative difference) in the realistic data set. The cumulative incidence of competing risk approach allows for appropriate accounting of competing risk and, as such, offers an improved ability to compare survival results across studies.}, added-at = {2023-02-03T11:44:35.000+0100}, author = {Fennema, P and Lubsen, J}, biburl = {https://www.bibsonomy.org/bibtex/262b12b1aa84535e7987da5d28dfc2d96/jepcastel}, city = {Netherlands Institute for Health Sciences, Rotterdam, The Netherlands. peter.fennema@smithnephew.com}, doi = {10.1302/0301-620X.92B5.23470}, interhash = {1fce8010b85b4bea93bda3ccbe670c34}, intrahash = {62b12b1aa84535e7987da5d28dfc2d96}, isbn = {0301-620X}, issn = {0301-620X}, journal = {The Journal of bone and joint surgery. British volume}, keywords = {Arthroplasty Bias(Epidemiology) DataInterpretation Hip Hip:mortality Hip:statistics&numericaldata HipProsthesis HipProsthesis:standards Humans Incidence Models OutcomeAssessment(HealthCare) OutcomeAssessment(HealthCare):methods ProsthesisDesign ProsthesisDesign:standards ProsthesisFailure Reoperation Reoperation:statistics&numericaldata Replacement Statistical SurvivalAnalysis Theoretical}, month = {5}, note = {5813<m:linebreak></m:linebreak>LR: 20101110; JID: 0375355; ppublish;<m:linebreak></m:linebreak>Anàlisi de supervivència; Competing risks}, number = 5, pages = {701-6}, pmid = {20436009}, timestamp = {2023-02-03T11:44:35.000+0100}, title = {Survival analysis in total joint replacement: an alternative method of accounting for the presence of competing risk.}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20436009}, volume = 92, year = 2010 }