The analysis of competing events like cause-specific mortality—beware of the Kaplan-Meier method

摘要

Kaplan–Meier analysis is a popular method used for analysing time-to-event data. In case of competing event analyses such as that of cardiovascular and non-cardiovascular mortality, however, the Kaplan–Meier method profoundly overestimates the cumulative mortality probabilities for each of the separate causes of death. This article provides an introduction to the problem of competing events in Kaplan–Meier analysis. It explains cumulative incidence competing risk analysis and demonstrates on a cohort of elderly dialysis patients that, in contrast to the Kaplan–Meier method, application of this method yields unbiased estimates of the cumulative probabilities for cause-specific mortality.