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Subtleties in the interpretation of hazard contrasts

Author

Listed:
  • Torben Martinussen

    (University of Copenhagen)

  • Stijn Vansteelandt

    (Ghent University
    London School of Hygiene and Tropical Medicine)

  • Per Kragh Andersen

    (University of Copenhagen)

Abstract

The hazard ratio is one of the most commonly reported measures of treatment effect in randomised trials, yet the source of much misinterpretation. This point was made clear by Hernán (Epidemiology (Cambridge, Mass) 21(1):13–15, 2010) in a commentary, which emphasised that the hazard ratio contrasts populations of treated and untreated individuals who survived a given period of time, populations that will typically fail to be comparable—even in a randomised trial—as a result of different pressures or intensities acting on different populations. The commentary has been very influential, but also a source of surprise and confusion. In this note, we aim to provide more insight into the subtle interpretation of hazard ratios and differences, by investigating in particular what can be learned about a treatment effect from the hazard ratio becoming 1 (or the hazard difference 0) after a certain period of time. We further define a hazard ratio that has a causal interpretation and study its relationship to the Cox hazard ratio, and we also define a causal hazard difference. These quantities are of theoretical interest only, however, since they rely on assumptions that cannot be empirically evaluated. Throughout, we will focus on the analysis of randomised experiments.

Suggested Citation

  • Torben Martinussen & Stijn Vansteelandt & Per Kragh Andersen, 2020. "Subtleties in the interpretation of hazard contrasts," Lifetime Data Analysis: An International Journal Devoted to Statistical Methods and Applications for Time-to-Event Data, Springer, vol. 26(4), pages 833-855, October.
  • Handle: RePEc:spr:lifeda:v:26:y:2020:i:4:d:10.1007_s10985-020-09501-5
    DOI: 10.1007/s10985-020-09501-5
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    References listed on IDEAS

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    1. Lihui Zhao & Brian Claggett & Lu Tian & Hajime Uno & Marc A. Pfeffer & Scott D. Solomon & Lorenzo Trippa & L. J. Wei, 2016. "On the restricted mean survival time curve in survival analysis," Biometrics, The International Biometric Society, vol. 72(1), pages 215-221, March.
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    Cited by:

    1. Rachel Axelrod & Daniel Nevo, 2023. "A sensitivity analysis approach for the causal hazard ratio in randomized and observational studies," Biometrics, The International Biometric Society, vol. 79(3), pages 2743-2756, September.
    2. Paul Frédéric Blanche & Anders Holt & Thomas Scheike, 2023. "On logistic regression with right censored data, with or without competing risks, and its use for estimating treatment effects," Lifetime Data Analysis: An International Journal Devoted to Statistical Methods and Applications for Time-to-Event Data, Springer, vol. 29(2), pages 441-482, April.
    3. Benjamin R. Baer & Robert L. Strawderman & Ashkan Ertefaie, 2023. "Discussion on “Instrumental variable estimation of the causal hazard ratio,” by Linbo Wang, Eric Tchetgen Tchetgen, Torben Martinussen, and Stijn Vansteelandt," Biometrics, The International Biometric Society, vol. 79(2), pages 554-558, June.
    4. Chengyuan Lu & Jelle Goeman & Hein Putter, 2023. "Maximum likelihood estimation in the additive hazards model," Biometrics, The International Biometric Society, vol. 79(3), pages 1646-1656, September.
    5. Tat-Thang Vo & Hilary Davies-Kershaw & Ruth Hackett & Stijn Vansteelandt, 2022. "Longitudinal mediation analysis of time-to-event endpoints in the presence of competing risks," Lifetime Data Analysis: An International Journal Devoted to Statistical Methods and Applications for Time-to-Event Data, Springer, vol. 28(3), pages 380-400, July.
    6. Mats J. Stensrud & Miguel A. Hernán & Eric J Tchetgen Tchetgen & James M. Robins & Vanessa Didelez & Jessica G. Young, 2021. "A generalized theory of separable effects in competing event settings," Lifetime Data Analysis: An International Journal Devoted to Statistical Methods and Applications for Time-to-Event Data, Springer, vol. 27(4), pages 588-631, October.
    7. Lu Mao, 2023. "Study design for restricted mean time analysis of recurrent events and death," Biometrics, The International Biometric Society, vol. 79(4), pages 3701-3714, December.
    8. Mariam O. Adeleke & Gianluca Baio & Aidan G. O'Keeffe, 2022. "Regression discontinuity designs for time‐to‐event outcomes: An approach using accelerated failure time models," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 185(3), pages 1216-1246, July.
    9. Ross L. Prentice, 2022. "On the targets of inference with multivariate failure time data," Lifetime Data Analysis: An International Journal Devoted to Statistical Methods and Applications for Time-to-Event Data, Springer, vol. 28(4), pages 546-559, October.

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