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Comparison of different approaches to estimating age standardized net survival.

Lambert PC, Dickman PW, Rutherford MJ - BMC Med Res Methodol (2015)

Bottom Line: We compare lifetable-based estimates (Ederer II), a new unbiased method based on inverse probability of censoring weights (Pohar Perme) and model-based estimates.However, both the Ederer II and modelling approaches have some advantages over the Pohar Perme method in terms of greater precision, particularly for longer-term follow-up (10 and 15 years).We have also shown advantages in using the more traditional and modelling methods.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Sciences, University of Leicester, University Road, Leicester, LE1 7RH, UK. paul.lambert@le.ac.uk.

ABSTRACT

Background: Age-standardized net survival provides an important population-based summary of cancer survival that appropriately accounts for differences in other-cause mortality rates and standardizes the population age distribution to allow fair comparisons. Recently, there has been debate over the most appropriate method for estimating this quantity, with the traditional Ederer II approach being shown to have potential bias.

Methods: We compare lifetable-based estimates (Ederer II), a new unbiased method based on inverse probability of censoring weights (Pohar Perme) and model-based estimates. We make the comparison in a simulation setting; generating scenarios where we would expect to see a large theoretical bias.

Results: Our simulations demonstrate that even in relatively extreme scenarios there is negligible bias in age-standardized net survival when using the age-standardized Ederer II method, modelling with continuous age or using the Pohar Perme method. However, both the Ederer II and modelling approaches have some advantages over the Pohar Perme method in terms of greater precision, particularly for longer-term follow-up (10 and 15 years).

Conclusions: Our results show that, when age-standardizing, concern over bias with the traditional methods is unfounded. We have also shown advantages in using the more traditional and modelling methods.

No MeSH data available.


Related in: MedlinePlus

Comparison of Different Approaches to Estimating Net Survival (with 95 % confidence intervals) for 2117 Men Aged 75+, Diagnosed with Cancer of the Rectum in England between 1992 and 2007. The Confidence Interval for the Pohar Perme Method is Shown by the Shaded Area
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Fig1: Comparison of Different Approaches to Estimating Net Survival (with 95 % confidence intervals) for 2117 Men Aged 75+, Diagnosed with Cancer of the Rectum in England between 1992 and 2007. The Confidence Interval for the Pohar Perme Method is Shown by the Shaded Area

Mentions: Figure 1 shows estimated net survival for cancer of rectum in England for those age 75+ estimated using three different methods described later (Ederer II, Pohar Perme and model based). It illustrates three key issues,(i) the methods give different estimates of net survival, particularly for long term follow up; (ii) the Pohar-Pohar estimate is more variable than the other methods; (iii) the confidence intervals for the Pohar-Perme estimate are wider.Fig. 1


Comparison of different approaches to estimating age standardized net survival.

Lambert PC, Dickman PW, Rutherford MJ - BMC Med Res Methodol (2015)

Comparison of Different Approaches to Estimating Net Survival (with 95 % confidence intervals) for 2117 Men Aged 75+, Diagnosed with Cancer of the Rectum in England between 1992 and 2007. The Confidence Interval for the Pohar Perme Method is Shown by the Shaded Area
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4537569&req=5

Fig1: Comparison of Different Approaches to Estimating Net Survival (with 95 % confidence intervals) for 2117 Men Aged 75+, Diagnosed with Cancer of the Rectum in England between 1992 and 2007. The Confidence Interval for the Pohar Perme Method is Shown by the Shaded Area
Mentions: Figure 1 shows estimated net survival for cancer of rectum in England for those age 75+ estimated using three different methods described later (Ederer II, Pohar Perme and model based). It illustrates three key issues,(i) the methods give different estimates of net survival, particularly for long term follow up; (ii) the Pohar-Pohar estimate is more variable than the other methods; (iii) the confidence intervals for the Pohar-Perme estimate are wider.Fig. 1

Bottom Line: We compare lifetable-based estimates (Ederer II), a new unbiased method based on inverse probability of censoring weights (Pohar Perme) and model-based estimates.However, both the Ederer II and modelling approaches have some advantages over the Pohar Perme method in terms of greater precision, particularly for longer-term follow-up (10 and 15 years).We have also shown advantages in using the more traditional and modelling methods.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Sciences, University of Leicester, University Road, Leicester, LE1 7RH, UK. paul.lambert@le.ac.uk.

ABSTRACT

Background: Age-standardized net survival provides an important population-based summary of cancer survival that appropriately accounts for differences in other-cause mortality rates and standardizes the population age distribution to allow fair comparisons. Recently, there has been debate over the most appropriate method for estimating this quantity, with the traditional Ederer II approach being shown to have potential bias.

Methods: We compare lifetable-based estimates (Ederer II), a new unbiased method based on inverse probability of censoring weights (Pohar Perme) and model-based estimates. We make the comparison in a simulation setting; generating scenarios where we would expect to see a large theoretical bias.

Results: Our simulations demonstrate that even in relatively extreme scenarios there is negligible bias in age-standardized net survival when using the age-standardized Ederer II method, modelling with continuous age or using the Pohar Perme method. However, both the Ederer II and modelling approaches have some advantages over the Pohar Perme method in terms of greater precision, particularly for longer-term follow-up (10 and 15 years).

Conclusions: Our results show that, when age-standardizing, concern over bias with the traditional methods is unfounded. We have also shown advantages in using the more traditional and modelling methods.

No MeSH data available.


Related in: MedlinePlus