Transforming cumulative hazard estimates

SUMMARYTime-to-event outcomes are often evaluated on the hazard scale, but interpreting hazards may be difficult. Recently in the causal inference literature concerns have been raised that hazards actually have a built-in selection bias that prevents simple causal interpretations. This is a problem even in randomized controlled trials, where hazard ratios have become a standard measure of treatment effects. Modelling on the hazard scale is nevertheless convenient, for example to adjust for covariates; using hazards for intermediate calculations may therefore be desirable. In this paper we present a generic method for transforming hazard estimates consistently to other scales at which these built-in selection biases are avoided. The method is based on differential equations and generalizes a well-known relation between the Nelson–Aalen and Kaplan–Meier estimators. Using the martingale central limit theorem, we show that covariances can be estimated consistently for a large class of estimators, thus allowing for rapid calculation of confidence intervals. Hence, given cumulative hazard estimates based on, for example, Aalen’s additive hazard model, we can obtain many other parameters without much more effort. We give several examples and the associated estimators. Coverage and convergence speed are explored via simulations, and the results suggest that reliable estimates can be obtained in real-life scenarios.