期刊
STATISTICS IN MEDICINE
卷 34, 期 21, 页码 2881-2898出版社
WILEY
DOI: 10.1002/sim.6556
关键词
meta-analysis; time-to-event outcomes; non-proportional hazards; restricted mean survival time
类别
资金
- UK Medical Research Council (MRC) [MSA7355QP21]
- MRC [MC_UU_12023/21] Funding Source: UKRI
- Medical Research Council [MC_UU_12023/21] Funding Source: researchfish
Meta-analysis of time-to-event outcomes using the hazard ratio as a treatment effect measure has an underlying assumption that hazards are proportional. The between-arm difference in the restricted mean survival time is a measure that avoids this assumption and allows the treatment effect to vary with time. We describe and evaluate meta-analysis based on the restricted mean survival time for dealing with non-proportional hazards and present a diagnostic method for the overall proportional hazards assumption. The methods are illustrated with the application to two individual participant meta-analyses in cancer. The examples were chosen because they differ in disease severity and the patterns of follow-up, in order to understand the potential impacts on the hazards and the overall effect estimates. We further investigate the estimation methods for restricted mean survival time by a simulation study. Copyright (c) 2015 John Wiley & Sons, Ltd.
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