Subdistribution hazard models for competing risks in discrete time

Biostatistics. 2020 Jul 1;21(3):449-466. doi: 10.1093/biostatistics/kxy069.

Abstract

A popular modeling approach for competing risks analysis in longitudinal studies is the proportional subdistribution hazards model by Fine and Gray (1999. A proportional hazards model for the subdistribution of a competing risk. Journal of the American Statistical Association94, 496-509). This model is widely used for the analysis of continuous event times in clinical and epidemiological studies. However, it does not apply when event times are measured on a discrete time scale, which is a likely scenario when events occur between pairs of consecutive points in time (e.g., between two follow-up visits of an epidemiological study) and when the exact lengths of the continuous time spans are not known. To adapt the Fine and Gray approach to this situation, we propose a technique for modeling subdistribution hazards in discrete time. Our method, which results in consistent and asymptotically normal estimators of the model parameters, is based on a weighted ML estimation scheme for binary regression. We illustrate the modeling approach by an analysis of nosocomial pneumonia in patients treated in hospitals.

Keywords: Competing risks; Discrete time-to-event data; Regression modeling; Subdistribution hazard; Survival analysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomedical Research / methods*
  • Biostatistics / methods*
  • Healthcare-Associated Pneumonia / epidemiology
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Models, Statistical*
  • Proportional Hazards Models