Covariate-adjusted measures of discrimination for survival data

Ian R. White, Eleni Rapsomaniki, S. G. Wannamethee, R. W. Morris, J. Willeit, P. Willeit, P. Santer, S. Kiechl, N. Wald, S. Ebrahim, D. A. Lawlor, J. Gallacher, J. W G Yarnell, Y. Ben-Shlomo, E. Casiglia, V. Tikhonoff, S. E. Sutherland, P. J. Nietert, J. E. Keil, D. L. BachmanB. M. Psaty, M. Cushman, B. G. Nordestgaard, A. Tybjærg-Hansen, R. Frikke-Schmidt, S. Giampaoli, L. Palmieri, S. Panico, L. Pilotto, D. Vanuzzo, L. A. Simons, Y. Friedlander, J. McCallum, J. F. Price, S. McLachlan, J. O. Taylor, J. M. Guralnik, R. B. Wallace, F. J. Kohout, J. C. Cornoni-Huntley, J. M. Guralnik, D. G. Blazer, J. M. Guralnik, C. L. Phillips, C. L. Phillips, J. M. Guralnik, N. J. Wareham, K. T. Khaw, H. Brenner, B. Schöttker, H. T. Müller, D. Rothenbacher, A. Nissinen, C. Donfrancesco, S. Giampaoli, K. Harald, P. R. Jousilahti, E. Vartiainen, V. Salomaa, R. B. D'Agostino, P. A. Wolf, R. S. Vasan, M. Daimon, T. Oizumi, T. Kayama, T. Kato, A. Chetrit, R. Dankner, F. Lubin, L. Welin, K. Svärdsudd, H. Eriksson, G. Lappas, L. Lissner, K. Mehlig, C. Björkelund, D. Nagel, Y. Kiyohara, H. Arima, T. Ninomiya, J. Hata, B. Rodriguez, J. M. Dekker, G. Nijpels, C. D A Stehouwer, H. Iso, A. Kitamura, K. Yamagishi, H. Noda, U. Goldbourt, J. Kauhanen, J. T. Salonen, T. P. Tuomainen, T. W. Meade, B. L. DeStavola, A. Blokstra, W. M M Verschuren, M. Cushman, I. H. de Boer, A. R. Folsom, B. M. Psaty, W. Koenig, C. Meisinger, A. Peters, W. M M Verschuren, H. B. Bueno-de-Mesquita, A. Blokstra, A. Rosengren, L. Wilhelmsen, G. Lappas, L. H. Kuller, G. Grandits, J. A. Cooper, K. A. Bauer, K. W. Davidson, S. Kirkland, J. A. Shaffer, D. Shimbo, A. Kitamura, H. Iso, S. Sato, R. P F Dullaart, S. J L Bakker, R. T. Gansevoort, P. Ducimetiere, P. Amouyel, D. Arveiler, A. Evans, J. Ferrières, H. Schulte, G. Assmann, J. W. Jukema, R. G J Westendorp, N. Sattar, B. Cantin, B. Lamarche, J. P. Després, [No Value] E.Barrett-Connor, D. L. Wingard, L. B. Daniels, V. Gudnason, T. Aspelund, M. Trevisan, A. Hofman, O. H. Franco, H. Tunstall-Pedoe, R. Tavendale, G. D O Lowe, M. Woodward, W. J. Howard, B. V. Howard, Y. Zhang, L. G. Best, J. Umans, Y. Ben-Shlomo, G. Davey-Smith, A. Onat, H. Nakagawa, M. Sakurai, K. Nakamura, Y. Morikawa, I. Njølstad, E. B. Mathiesen, T. Wilsgaard, J. Sundström, J. M. Gaziano, P. M. Ridker, M. Marmot, R. Clarke, R. Collins, A. Fletcher, E. Brunner, M. Shipley, M. Kivimaki, P. M. Ridker, J. Buring, N. Rifai, N. Cook, I. Ford, M. Robertson, A. Marín Ibañez, E. J M Feskens, J. M. Geleijnse

Research output: Contribution to journalArticle

Abstract

Motivation: Discrimination statistics describe the ability of a survival model to assign higher risks to individuals who experience earlier events: examples are Harrell's C-index and Royston and Sauerbrei's D, which we call the D-index. Prognostic covariates whose distributions are controlled by the study design (e.g. age and sex) influence discrimination and can make it difficult to compare model discrimination between studies. Although covariate adjustment is a standard procedure for quantifying disease-risk factor associations, there are no covariate adjustment methods for discrimination statistics in censored survival data. Objective: To develop extensions of the C-index and D-index that describe the prognostic ability of a model adjusted for one or more covariate(s). Method: We define a covariate-adjusted C-index and D-index for censored survival data, propose several estimators, and investigate their performance in simulation studies and in data from a large individual participant data meta-analysis, the Emerging Risk Factors Collaboration. Results: The proposed methods perform well in simulations. In the Emerging Risk Factors Collaboration data, the age-adjusted C-index and D-index were substantially smaller than unadjusted values. The study-specific standard deviation of baseline age was strongly associated with the unadjusted C-index and D-index but not significantly associated with the age-adjusted indices. Conclusions: The proposed estimators improve meta-analysis comparisons, are easy to implement and give a more meaningful clinical interpretation.

Original languageEnglish (US)
Pages (from-to)592-613
Number of pages22
JournalBiometrical Journal
Volume57
Issue number4
DOIs
StatePublished - Jul 1 2015
Externally publishedYes

Fingerprint

Survival Data
Discrimination
Covariates
Social Adjustment
Aptitude
Meta-Analysis
Sexism
Risk Factors
Censored Survival Data
Adjustment
Model Discrimination
Statistics
Estimator
Survival Model
Standard deviation
Assign
Baseline
Simulation Study

Keywords

  • C-index
  • D-index
  • Discrimination

ASJC Scopus subject areas

  • Statistics and Probability
  • Medicine(all)
  • Statistics, Probability and Uncertainty

Cite this

White, I. R., Rapsomaniki, E., Wannamethee, S. G., Morris, R. W., Willeit, J., Willeit, P., ... Geleijnse, J. M. (2015). Covariate-adjusted measures of discrimination for survival data. Biometrical Journal, 57(4), 592-613. https://doi.org/10.1002/bimj.201400061

Covariate-adjusted measures of discrimination for survival data. / White, Ian R.; Rapsomaniki, Eleni; Wannamethee, S. G.; Morris, R. W.; Willeit, J.; Willeit, P.; Santer, P.; Kiechl, S.; Wald, N.; Ebrahim, S.; Lawlor, D. A.; Gallacher, J.; Yarnell, J. W G; Ben-Shlomo, Y.; Casiglia, E.; Tikhonoff, V.; Sutherland, S. E.; Nietert, P. J.; Keil, J. E.; Bachman, D. L.; Psaty, B. M.; Cushman, M.; Nordestgaard, B. G.; Tybjærg-Hansen, A.; Frikke-Schmidt, R.; Giampaoli, S.; Palmieri, L.; Panico, S.; Pilotto, L.; Vanuzzo, D.; Simons, L. A.; Friedlander, Y.; McCallum, J.; Price, J. F.; McLachlan, S.; Taylor, J. O.; Guralnik, J. M.; Wallace, R. B.; Kohout, F. J.; Cornoni-Huntley, J. C.; Guralnik, J. M.; Blazer, D. G.; Guralnik, J. M.; Phillips, C. L.; Phillips, C. L.; Guralnik, J. M.; Wareham, N. J.; Khaw, K. T.; Brenner, H.; Schöttker, B.; Müller, H. T.; Rothenbacher, D.; Nissinen, A.; Donfrancesco, C.; Giampaoli, S.; Harald, K.; Jousilahti, P. R.; Vartiainen, E.; Salomaa, V.; D'Agostino, R. B.; Wolf, P. A.; Vasan, R. S.; Daimon, M.; Oizumi, T.; Kayama, T.; Kato, T.; Chetrit, A.; Dankner, R.; Lubin, F.; Welin, L.; Svärdsudd, K.; Eriksson, H.; Lappas, G.; Lissner, L.; Mehlig, K.; Björkelund, C.; Nagel, D.; Kiyohara, Y.; Arima, H.; Ninomiya, T.; Hata, J.; Rodriguez, B.; Dekker, J. M.; Nijpels, G.; Stehouwer, C. D A; Iso, H.; Kitamura, A.; Yamagishi, K.; Noda, H.; Goldbourt, U.; Kauhanen, J.; Salonen, J. T.; Tuomainen, T. P.; Meade, T. W.; DeStavola, B. L.; Blokstra, A.; Verschuren, W. M M; Cushman, M.; de Boer, I. H.; Folsom, A. R.; Psaty, B. M.; Koenig, W.; Meisinger, C.; Peters, A.; Verschuren, W. M M; Bueno-de-Mesquita, H. B.; Blokstra, A.; Rosengren, A.; Wilhelmsen, L.; Lappas, G.; Kuller, L. H.; Grandits, G.; Cooper, J. A.; Bauer, K. A.; Davidson, K. W.; Kirkland, S.; Shaffer, J. A.; Shimbo, D.; Kitamura, A.; Iso, H.; Sato, S.; Dullaart, R. P F; Bakker, S. J L; Gansevoort, R. T.; Ducimetiere, P.; Amouyel, P.; Arveiler, D.; Evans, A.; Ferrières, J.; Schulte, H.; Assmann, G.; Jukema, J. W.; Westendorp, R. G J; Sattar, N.; Cantin, B.; Lamarche, B.; Després, J. P.; E.Barrett-Connor, [No Value]; Wingard, D. L.; Daniels, L. B.; Gudnason, V.; Aspelund, T.; Trevisan, M.; Hofman, A.; Franco, O. H.; Tunstall-Pedoe, H.; Tavendale, R.; Lowe, G. D O; Woodward, M.; Howard, W. J.; Howard, B. V.; Zhang, Y.; Best, L. G.; Umans, J.; Ben-Shlomo, Y.; Davey-Smith, G.; Onat, A.; Nakagawa, H.; Sakurai, M.; Nakamura, K.; Morikawa, Y.; Njølstad, I.; Mathiesen, E. B.; Wilsgaard, T.; Sundström, J.; Gaziano, J. M.; Ridker, P. M.; Marmot, M.; Clarke, R.; Collins, R.; Fletcher, A.; Brunner, E.; Shipley, M.; Kivimaki, M.; Ridker, P. M.; Buring, J.; Rifai, N.; Cook, N.; Ford, I.; Robertson, M.; Marín Ibañez, A.; Feskens, E. J M; Geleijnse, J. M.

In: Biometrical Journal, Vol. 57, No. 4, 01.07.2015, p. 592-613.

Research output: Contribution to journalArticle

White, IR, Rapsomaniki, E, Wannamethee, SG, Morris, RW, Willeit, J, Willeit, P, Santer, P, Kiechl, S, Wald, N, Ebrahim, S, Lawlor, DA, Gallacher, J, Yarnell, JWG, Ben-Shlomo, Y, Casiglia, E, Tikhonoff, V, Sutherland, SE, Nietert, PJ, Keil, JE, Bachman, DL, Psaty, BM, Cushman, M, Nordestgaard, BG, Tybjærg-Hansen, A, Frikke-Schmidt, R, Giampaoli, S, Palmieri, L, Panico, S, Pilotto, L, Vanuzzo, D, Simons, LA, Friedlander, Y, McCallum, J, Price, JF, McLachlan, S, Taylor, JO, Guralnik, JM, Wallace, RB, Kohout, FJ, Cornoni-Huntley, JC, Guralnik, JM, Blazer, DG, Guralnik, JM, Phillips, CL, Phillips, CL, Guralnik, JM, Wareham, NJ, Khaw, KT, Brenner, H, Schöttker, B, Müller, HT, Rothenbacher, D, Nissinen, A, Donfrancesco, C, Giampaoli, S, Harald, K, Jousilahti, PR, Vartiainen, E, Salomaa, V, D'Agostino, RB, Wolf, PA, Vasan, RS, Daimon, M, Oizumi, T, Kayama, T, Kato, T, Chetrit, A, Dankner, R, Lubin, F, Welin, L, Svärdsudd, K, Eriksson, H, Lappas, G, Lissner, L, Mehlig, K, Björkelund, C, Nagel, D, Kiyohara, Y, Arima, H, Ninomiya, T, Hata, J, Rodriguez, B, Dekker, JM, Nijpels, G, Stehouwer, CDA, Iso, H, Kitamura, A, Yamagishi, K, Noda, H, Goldbourt, U, Kauhanen, J, Salonen, JT, Tuomainen, TP, Meade, TW, DeStavola, BL, Blokstra, A, Verschuren, WMM, Cushman, M, de Boer, IH, Folsom, AR, Psaty, BM, Koenig, W, Meisinger, C, Peters, A, Verschuren, WMM, Bueno-de-Mesquita, HB, Blokstra, A, Rosengren, A, Wilhelmsen, L, Lappas, G, Kuller, LH, Grandits, G, Cooper, JA, Bauer, KA, Davidson, KW, Kirkland, S, Shaffer, JA, Shimbo, D, Kitamura, A, Iso, H, Sato, S, Dullaart, RPF, Bakker, SJL, Gansevoort, RT, Ducimetiere, P, Amouyel, P, Arveiler, D, Evans, A, Ferrières, J, Schulte, H, Assmann, G, Jukema, JW, Westendorp, RGJ, Sattar, N, Cantin, B, Lamarche, B, Després, JP, E.Barrett-Connor, NV, Wingard, DL, Daniels, LB, Gudnason, V, Aspelund, T, Trevisan, M, Hofman, A, Franco, OH, Tunstall-Pedoe, H, Tavendale, R, Lowe, GDO, Woodward, M, Howard, WJ, Howard, BV, Zhang, Y, Best, LG, Umans, J, Ben-Shlomo, Y, Davey-Smith, G, Onat, A, Nakagawa, H, Sakurai, M, Nakamura, K, Morikawa, Y, Njølstad, I, Mathiesen, EB, Wilsgaard, T, Sundström, J, Gaziano, JM, Ridker, PM, Marmot, M, Clarke, R, Collins, R, Fletcher, A, Brunner, E, Shipley, M, Kivimaki, M, Ridker, PM, Buring, J, Rifai, N, Cook, N, Ford, I, Robertson, M, Marín Ibañez, A, Feskens, EJM & Geleijnse, JM 2015, 'Covariate-adjusted measures of discrimination for survival data', Biometrical Journal, vol. 57, no. 4, pp. 592-613. https://doi.org/10.1002/bimj.201400061
White IR, Rapsomaniki E, Wannamethee SG, Morris RW, Willeit J, Willeit P et al. Covariate-adjusted measures of discrimination for survival data. Biometrical Journal. 2015 Jul 1;57(4):592-613. https://doi.org/10.1002/bimj.201400061
White, Ian R. ; Rapsomaniki, Eleni ; Wannamethee, S. G. ; Morris, R. W. ; Willeit, J. ; Willeit, P. ; Santer, P. ; Kiechl, S. ; Wald, N. ; Ebrahim, S. ; Lawlor, D. A. ; Gallacher, J. ; Yarnell, J. W G ; Ben-Shlomo, Y. ; Casiglia, E. ; Tikhonoff, V. ; Sutherland, S. E. ; Nietert, P. J. ; Keil, J. E. ; Bachman, D. L. ; Psaty, B. M. ; Cushman, M. ; Nordestgaard, B. G. ; Tybjærg-Hansen, A. ; Frikke-Schmidt, R. ; Giampaoli, S. ; Palmieri, L. ; Panico, S. ; Pilotto, L. ; Vanuzzo, D. ; Simons, L. A. ; Friedlander, Y. ; McCallum, J. ; Price, J. F. ; McLachlan, S. ; Taylor, J. O. ; Guralnik, J. M. ; Wallace, R. B. ; Kohout, F. J. ; Cornoni-Huntley, J. C. ; Guralnik, J. M. ; Blazer, D. G. ; Guralnik, J. M. ; Phillips, C. L. ; Phillips, C. L. ; Guralnik, J. M. ; Wareham, N. J. ; Khaw, K. T. ; Brenner, H. ; Schöttker, B. ; Müller, H. T. ; Rothenbacher, D. ; Nissinen, A. ; Donfrancesco, C. ; Giampaoli, S. ; Harald, K. ; Jousilahti, P. R. ; Vartiainen, E. ; Salomaa, V. ; D'Agostino, R. B. ; Wolf, P. A. ; Vasan, R. S. ; Daimon, M. ; Oizumi, T. ; Kayama, T. ; Kato, T. ; Chetrit, A. ; Dankner, R. ; Lubin, F. ; Welin, L. ; Svärdsudd, K. ; Eriksson, H. ; Lappas, G. ; Lissner, L. ; Mehlig, K. ; Björkelund, C. ; Nagel, D. ; Kiyohara, Y. ; Arima, H. ; Ninomiya, T. ; Hata, J. ; Rodriguez, B. ; Dekker, J. M. ; Nijpels, G. ; Stehouwer, C. D A ; Iso, H. ; Kitamura, A. ; Yamagishi, K. ; Noda, H. ; Goldbourt, U. ; Kauhanen, J. ; Salonen, J. T. ; Tuomainen, T. P. ; Meade, T. W. ; DeStavola, B. L. ; Blokstra, A. ; Verschuren, W. M M ; Cushman, M. ; de Boer, I. H. ; Folsom, A. R. ; Psaty, B. M. ; Koenig, W. ; Meisinger, C. ; Peters, A. ; Verschuren, W. M M ; Bueno-de-Mesquita, H. B. ; Blokstra, A. ; Rosengren, A. ; Wilhelmsen, L. ; Lappas, G. ; Kuller, L. H. ; Grandits, G. ; Cooper, J. A. ; Bauer, K. A. ; Davidson, K. W. ; Kirkland, S. ; Shaffer, J. A. ; Shimbo, D. ; Kitamura, A. ; Iso, H. ; Sato, S. ; Dullaart, R. P F ; Bakker, S. J L ; Gansevoort, R. T. ; Ducimetiere, P. ; Amouyel, P. ; Arveiler, D. ; Evans, A. ; Ferrières, J. ; Schulte, H. ; Assmann, G. ; Jukema, J. W. ; Westendorp, R. G J ; Sattar, N. ; Cantin, B. ; Lamarche, B. ; Després, J. P. ; E.Barrett-Connor, [No Value] ; Wingard, D. L. ; Daniels, L. B. ; Gudnason, V. ; Aspelund, T. ; Trevisan, M. ; Hofman, A. ; Franco, O. H. ; Tunstall-Pedoe, H. ; Tavendale, R. ; Lowe, G. D O ; Woodward, M. ; Howard, W. J. ; Howard, B. V. ; Zhang, Y. ; Best, L. G. ; Umans, J. ; Ben-Shlomo, Y. ; Davey-Smith, G. ; Onat, A. ; Nakagawa, H. ; Sakurai, M. ; Nakamura, K. ; Morikawa, Y. ; Njølstad, I. ; Mathiesen, E. B. ; Wilsgaard, T. ; Sundström, J. ; Gaziano, J. M. ; Ridker, P. M. ; Marmot, M. ; Clarke, R. ; Collins, R. ; Fletcher, A. ; Brunner, E. ; Shipley, M. ; Kivimaki, M. ; Ridker, P. M. ; Buring, J. ; Rifai, N. ; Cook, N. ; Ford, I. ; Robertson, M. ; Marín Ibañez, A. ; Feskens, E. J M ; Geleijnse, J. M. / Covariate-adjusted measures of discrimination for survival data. In: Biometrical Journal. 2015 ; Vol. 57, No. 4. pp. 592-613.
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title = "Covariate-adjusted measures of discrimination for survival data",
abstract = "Motivation: Discrimination statistics describe the ability of a survival model to assign higher risks to individuals who experience earlier events: examples are Harrell's C-index and Royston and Sauerbrei's D, which we call the D-index. Prognostic covariates whose distributions are controlled by the study design (e.g. age and sex) influence discrimination and can make it difficult to compare model discrimination between studies. Although covariate adjustment is a standard procedure for quantifying disease-risk factor associations, there are no covariate adjustment methods for discrimination statistics in censored survival data. Objective: To develop extensions of the C-index and D-index that describe the prognostic ability of a model adjusted for one or more covariate(s). Method: We define a covariate-adjusted C-index and D-index for censored survival data, propose several estimators, and investigate their performance in simulation studies and in data from a large individual participant data meta-analysis, the Emerging Risk Factors Collaboration. Results: The proposed methods perform well in simulations. In the Emerging Risk Factors Collaboration data, the age-adjusted C-index and D-index were substantially smaller than unadjusted values. The study-specific standard deviation of baseline age was strongly associated with the unadjusted C-index and D-index but not significantly associated with the age-adjusted indices. Conclusions: The proposed estimators improve meta-analysis comparisons, are easy to implement and give a more meaningful clinical interpretation.",
keywords = "C-index, D-index, Discrimination",
author = "White, {Ian R.} and Eleni Rapsomaniki and Wannamethee, {S. G.} and Morris, {R. W.} and J. Willeit and P. Willeit and P. Santer and S. Kiechl and N. Wald and S. Ebrahim and Lawlor, {D. A.} and J. Gallacher and Yarnell, {J. W G} and Y. Ben-Shlomo and E. Casiglia and V. Tikhonoff and Sutherland, {S. E.} and Nietert, {P. J.} and Keil, {J. E.} and Bachman, {D. L.} and Psaty, {B. M.} and M. Cushman and Nordestgaard, {B. G.} and A. Tybj{\ae}rg-Hansen and R. Frikke-Schmidt and S. Giampaoli and L. Palmieri and S. Panico and L. Pilotto and D. Vanuzzo and Simons, {L. A.} and Y. Friedlander and J. McCallum and Price, {J. F.} and S. McLachlan and Taylor, {J. O.} and Guralnik, {J. M.} and Wallace, {R. B.} and Kohout, {F. J.} and Cornoni-Huntley, {J. C.} and Guralnik, {J. M.} and Blazer, {D. G.} and Guralnik, {J. M.} and Phillips, {C. L.} and Phillips, {C. L.} and Guralnik, {J. M.} and Wareham, {N. J.} and Khaw, {K. T.} and H. Brenner and B. Sch{\"o}ttker and M{\"u}ller, {H. T.} and D. Rothenbacher and A. Nissinen and C. Donfrancesco and S. Giampaoli and K. Harald and Jousilahti, {P. R.} and E. Vartiainen and V. Salomaa and D'Agostino, {R. B.} and Wolf, {P. A.} and Vasan, {R. S.} and M. Daimon and T. Oizumi and T. Kayama and T. Kato and A. Chetrit and R. Dankner and F. Lubin and L. Welin and K. Sv{\"a}rdsudd and H. Eriksson and G. Lappas and L. Lissner and K. Mehlig and C. Bj{\"o}rkelund and D. Nagel and Y. Kiyohara and H. Arima and T. Ninomiya and J. Hata and B. Rodriguez and Dekker, {J. M.} and G. Nijpels and Stehouwer, {C. D A} and H. Iso and A. Kitamura and K. Yamagishi and H. Noda and U. Goldbourt and J. Kauhanen and Salonen, {J. T.} and Tuomainen, {T. P.} and Meade, {T. W.} and DeStavola, {B. L.} and A. Blokstra and Verschuren, {W. M M} and M. Cushman and {de Boer}, {I. H.} and Folsom, {A. R.} and Psaty, {B. M.} and W. Koenig and C. Meisinger and A. Peters and Verschuren, {W. M M} and Bueno-de-Mesquita, {H. B.} and A. Blokstra and A. Rosengren and L. Wilhelmsen and G. Lappas and Kuller, {L. H.} and G. Grandits and Cooper, {J. A.} and Bauer, {K. A.} and Davidson, {K. W.} and S. Kirkland and Shaffer, {J. A.} and D. Shimbo and A. Kitamura and H. Iso and S. Sato and Dullaart, {R. P F} and Bakker, {S. J L} and Gansevoort, {R. T.} and P. Ducimetiere and P. Amouyel and D. Arveiler and A. Evans and J. Ferri{\`e}res and H. Schulte and G. Assmann and Jukema, {J. W.} and Westendorp, {R. G J} and N. Sattar and B. Cantin and B. Lamarche and Despr{\'e}s, {J. P.} and E.Barrett-Connor, {[No Value]} and Wingard, {D. L.} and Daniels, {L. B.} and V. Gudnason and T. Aspelund and M. Trevisan and A. Hofman and Franco, {O. H.} and H. Tunstall-Pedoe and R. Tavendale and Lowe, {G. D O} and M. Woodward and Howard, {W. J.} and Howard, {B. V.} and Y. Zhang and Best, {L. G.} and J. Umans and Y. Ben-Shlomo and G. Davey-Smith and A. Onat and H. Nakagawa and M. Sakurai and K. Nakamura and Y. Morikawa and I. Nj{\o}lstad and Mathiesen, {E. B.} and T. Wilsgaard and J. Sundstr{\"o}m and Gaziano, {J. M.} and Ridker, {P. M.} and M. Marmot and R. Clarke and R. Collins and A. Fletcher and E. Brunner and M. Shipley and M. Kivimaki and Ridker, {P. M.} and J. Buring and N. Rifai and N. Cook and I. Ford and M. Robertson and {Mar{\'i}n Iba{\~n}ez}, A. and Feskens, {E. J M} and Geleijnse, {J. M.}",
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TY - JOUR

T1 - Covariate-adjusted measures of discrimination for survival data

AU - White, Ian R.

AU - Rapsomaniki, Eleni

AU - Wannamethee, S. G.

AU - Morris, R. W.

AU - Willeit, J.

AU - Willeit, P.

AU - Santer, P.

AU - Kiechl, S.

AU - Wald, N.

AU - Ebrahim, S.

AU - Lawlor, D. A.

AU - Gallacher, J.

AU - Yarnell, J. W G

AU - Ben-Shlomo, Y.

AU - Casiglia, E.

AU - Tikhonoff, V.

AU - Sutherland, S. E.

AU - Nietert, P. J.

AU - Keil, J. E.

AU - Bachman, D. L.

AU - Psaty, B. M.

AU - Cushman, M.

AU - Nordestgaard, B. G.

AU - Tybjærg-Hansen, A.

AU - Frikke-Schmidt, R.

AU - Giampaoli, S.

AU - Palmieri, L.

AU - Panico, S.

AU - Pilotto, L.

AU - Vanuzzo, D.

AU - Simons, L. A.

AU - Friedlander, Y.

AU - McCallum, J.

AU - Price, J. F.

AU - McLachlan, S.

AU - Taylor, J. O.

AU - Guralnik, J. M.

AU - Wallace, R. B.

AU - Kohout, F. J.

AU - Cornoni-Huntley, J. C.

AU - Guralnik, J. M.

AU - Blazer, D. G.

AU - Guralnik, J. M.

AU - Phillips, C. L.

AU - Phillips, C. L.

AU - Guralnik, J. M.

AU - Wareham, N. J.

AU - Khaw, K. T.

AU - Brenner, H.

AU - Schöttker, B.

AU - Müller, H. T.

AU - Rothenbacher, D.

AU - Nissinen, A.

AU - Donfrancesco, C.

AU - Giampaoli, S.

AU - Harald, K.

AU - Jousilahti, P. R.

AU - Vartiainen, E.

AU - Salomaa, V.

AU - D'Agostino, R. B.

AU - Wolf, P. A.

AU - Vasan, R. S.

AU - Daimon, M.

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PY - 2015/7/1

Y1 - 2015/7/1

N2 - Motivation: Discrimination statistics describe the ability of a survival model to assign higher risks to individuals who experience earlier events: examples are Harrell's C-index and Royston and Sauerbrei's D, which we call the D-index. Prognostic covariates whose distributions are controlled by the study design (e.g. age and sex) influence discrimination and can make it difficult to compare model discrimination between studies. Although covariate adjustment is a standard procedure for quantifying disease-risk factor associations, there are no covariate adjustment methods for discrimination statistics in censored survival data. Objective: To develop extensions of the C-index and D-index that describe the prognostic ability of a model adjusted for one or more covariate(s). Method: We define a covariate-adjusted C-index and D-index for censored survival data, propose several estimators, and investigate their performance in simulation studies and in data from a large individual participant data meta-analysis, the Emerging Risk Factors Collaboration. Results: The proposed methods perform well in simulations. In the Emerging Risk Factors Collaboration data, the age-adjusted C-index and D-index were substantially smaller than unadjusted values. The study-specific standard deviation of baseline age was strongly associated with the unadjusted C-index and D-index but not significantly associated with the age-adjusted indices. Conclusions: The proposed estimators improve meta-analysis comparisons, are easy to implement and give a more meaningful clinical interpretation.

AB - Motivation: Discrimination statistics describe the ability of a survival model to assign higher risks to individuals who experience earlier events: examples are Harrell's C-index and Royston and Sauerbrei's D, which we call the D-index. Prognostic covariates whose distributions are controlled by the study design (e.g. age and sex) influence discrimination and can make it difficult to compare model discrimination between studies. Although covariate adjustment is a standard procedure for quantifying disease-risk factor associations, there are no covariate adjustment methods for discrimination statistics in censored survival data. Objective: To develop extensions of the C-index and D-index that describe the prognostic ability of a model adjusted for one or more covariate(s). Method: We define a covariate-adjusted C-index and D-index for censored survival data, propose several estimators, and investigate their performance in simulation studies and in data from a large individual participant data meta-analysis, the Emerging Risk Factors Collaboration. Results: The proposed methods perform well in simulations. In the Emerging Risk Factors Collaboration data, the age-adjusted C-index and D-index were substantially smaller than unadjusted values. The study-specific standard deviation of baseline age was strongly associated with the unadjusted C-index and D-index but not significantly associated with the age-adjusted indices. Conclusions: The proposed estimators improve meta-analysis comparisons, are easy to implement and give a more meaningful clinical interpretation.

KW - C-index

KW - D-index

KW - Discrimination

UR - http://www.scopus.com/inward/record.url?scp=84933514328&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84933514328&partnerID=8YFLogxK

U2 - 10.1002/bimj.201400061

DO - 10.1002/bimj.201400061

M3 - Article

C2 - 25530064

AN - SCOPUS:84933514328

VL - 57

SP - 592

EP - 613

JO - Biometrical Journal

JF - Biometrical Journal

SN - 0323-3847

IS - 4

ER -