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Meta-analysis of time-to-event outcomes from randomized trials using restricted mean survival time: application to individual participant data.


ABSTRACT: 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.

SUBMITTER: Wei Y 

PROVIDER: S-EPMC5695659 | biostudies-literature | 2015 Sep

REPOSITORIES: biostudies-literature

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Meta-analysis of time-to-event outcomes from randomized trials using restricted mean survival time: application to individual participant data.

Wei Yinghui Y   Royston Patrick P   Tierney Jayne F JF   Parmar Mahesh K B MK  

Statistics in medicine 20150623 21


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 hazard  ...[more]

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