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A Decision-Theoretic Method for Analyzing Crossing Survival Curves in Healthcare

Author

Listed:
  • Appelbaum, Elie
  • Leshno, Moshe
  • Prisman, Eitan
  • Prisman, Eliezer, Z.

Abstract

The problem of crossing Kaplan-Meier curves has not been solved in the medical research literature to date. This paper integrates survival curve comparisons into decision theory, providing a theoretical framework and a solution to the problem of crossing Kaplan-Meier curves. The application of decision theory allows us to apply stochastic dominance concepts and risk preference attributes to compare treatments even when standard Kaplan-Meier curves cross. The paper shows that as additional risk preference attributes are adopted, Kaplan-Meier curves can be ranked under weaker restrictions, namely with higher orders of stochastic dominance. Consequently, even Kaplan-Meier curves that cross may be ranked. The method we present allows us to extract all possible information from survival functions; hence, superior treatments that cannot be identified using standard Kaplan-Meier curves may become identifiable. Our methodology is applied to two examples of published empirical medical studies. We show that treatments deemed non-comparable because their Kaplan-Meier curves intersect can be compared using our method.

Suggested Citation

  • Appelbaum, Elie & Leshno, Moshe & Prisman, Eitan & Prisman, Eliezer, Z., 2025. "A Decision-Theoretic Method for Analyzing Crossing Survival Curves in Healthcare," MPRA Paper 124419, University Library of Munich, Germany.
  • Handle: RePEc:pra:mprapa:124419
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    References listed on IDEAS

    as
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    More about this item

    Keywords

    Survival Curve Analysis; Decision Theory; Risk Preference Modelling; Stochastic Dominance; Medical Treatment Comparison; Healthcare Data Interpretation;
    All these keywords.

    JEL classification:

    • C18 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Methodolical Issues: General
    • C65 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling - - - Miscellaneous Mathematical Tools
    • D81 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Criteria for Decision-Making under Risk and Uncertainty
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I19 - Health, Education, and Welfare - - Health - - - Other

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