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J Clin Epidemiol. 2013 Jun;66(6):648-53. doi: 10.1016/j.jclinepi.2012.09.017. Epub 2013 Feb 14.

A competing risks analysis should report results on all cause-specific hazards and cumulative incidence functions.

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Conservatoire National des Arts et Métiers, IMATH, 292 Rue Saint Martin, Case 441, EA4629 Paris, France.


Competing risks endpoints are frequently encountered in hematopoietic stem cell transplantation where patients are exposed to relapse and treatment-related mortality. Both cause-specific hazards and direct models for the cumulative incidence functions have been used for analyzing such competing risks endpoints. For both approaches, the popular models are of a proportional hazards type. Such models have been used for studying prognostic factors in acute and chronic leukemias. We argue that a complete understanding of the event dynamics requires that both hazards and cumulative incidence be analyzed side by side, and that this is generally the most rigorous scientific approach to analyzing competing risks data. That is, understanding the effects of covariates on cause-specific hazards and cumulative incidence functions go hand in hand. A case study illustrates our proposal.

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