Competing risks and the clinical community: irrelevance or ignorance?

Life expectancy has dramatically increased in industrialized nations over the last 200 hundred years. The aging of populations carries over to clinical research and leads to an increasing representation of elderly and multimorbid individuals in study populations. Clinical research in these populatio...

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Main Authors: Koller, M, Raatz, H, Steyerberg, E, Wolbers, M
Format: Journal article
Language:English
Published: 2012
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author Koller, M
Raatz, H
Steyerberg, E
Wolbers, M
author_facet Koller, M
Raatz, H
Steyerberg, E
Wolbers, M
author_sort Koller, M
collection OXFORD
description Life expectancy has dramatically increased in industrialized nations over the last 200 hundred years. The aging of populations carries over to clinical research and leads to an increasing representation of elderly and multimorbid individuals in study populations. Clinical research in these populations is complicated by the fact that individuals are likely to experience several potential disease endpoints that prevent some disease-specific endpoint of interest from occurrence. Large developments in competing risks methodology have been achieved over the last decades, but we assume that recognition of competing risks in the clinical community is still marginal. It is the aim of this article to address translational aspects of competing risks to the clinical community. We describe clinical populations where competing risks issues may arise. We then discuss the importance of agreement between the competing risks methodology and the study aim, in particular the distinction between etiologic and prognostic research questions. In a review of 50 clinical studies performed in individuals susceptible to competing risks published in high-impact clinical journals, we found competing risks issues in 70% of all articles. Better recognition of issues related to competing risks and of statistical methods that deal with competing risks in accordance with the aim of the study is needed.
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spelling oxford-uuid:85fe3c28-6e60-49d6-ae8c-966d54c4f1cc2022-03-26T22:01:11ZCompeting risks and the clinical community: irrelevance or ignorance?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:85fe3c28-6e60-49d6-ae8c-966d54c4f1ccEnglishSymplectic Elements at Oxford2012Koller, MRaatz, HSteyerberg, EWolbers, MLife expectancy has dramatically increased in industrialized nations over the last 200 hundred years. The aging of populations carries over to clinical research and leads to an increasing representation of elderly and multimorbid individuals in study populations. Clinical research in these populations is complicated by the fact that individuals are likely to experience several potential disease endpoints that prevent some disease-specific endpoint of interest from occurrence. Large developments in competing risks methodology have been achieved over the last decades, but we assume that recognition of competing risks in the clinical community is still marginal. It is the aim of this article to address translational aspects of competing risks to the clinical community. We describe clinical populations where competing risks issues may arise. We then discuss the importance of agreement between the competing risks methodology and the study aim, in particular the distinction between etiologic and prognostic research questions. In a review of 50 clinical studies performed in individuals susceptible to competing risks published in high-impact clinical journals, we found competing risks issues in 70% of all articles. Better recognition of issues related to competing risks and of statistical methods that deal with competing risks in accordance with the aim of the study is needed.
spellingShingle Koller, M
Raatz, H
Steyerberg, E
Wolbers, M
Competing risks and the clinical community: irrelevance or ignorance?
title Competing risks and the clinical community: irrelevance or ignorance?
title_full Competing risks and the clinical community: irrelevance or ignorance?
title_fullStr Competing risks and the clinical community: irrelevance or ignorance?
title_full_unstemmed Competing risks and the clinical community: irrelevance or ignorance?
title_short Competing risks and the clinical community: irrelevance or ignorance?
title_sort competing risks and the clinical community irrelevance or ignorance
work_keys_str_mv AT kollerm competingrisksandtheclinicalcommunityirrelevanceorignorance
AT raatzh competingrisksandtheclinicalcommunityirrelevanceorignorance
AT steyerberge competingrisksandtheclinicalcommunityirrelevanceorignorance
AT wolbersm competingrisksandtheclinicalcommunityirrelevanceorignorance