Core Concepts in Pharmacoepidemiology: Time-To-Event Analysis Approaches in Pharmacoepidemiology.

Abstract

This article provides an overview of time-to-event (TTE) analysis in pharmacoepidemiology. The key concept of censoring is reviewed, including right-, left-, interval- and informative censoring. Simple descriptive statistics are explained, including the nonparametric estimation of the TTE distribution as per Kaplan-Meier method, as well as more complex TTE regression approaches, including the parametric Accelerated Failure Time (AFT) model and the semi-parametric Cox Proportional Hazards and Restricted Mean Survival Time (RMST) models. Additional approaches and various TTE model extensions are presented as well. Finally, causal inference for TTE outcomes is addressed. A thorough review of the available concepts and methods outlines the immense variety of available and useful TTE models. There may be underused TTE concepts and methods, which are highlighted to raise awareness for researchers who aim to apply the most appropriate TTE approach for their study. This paper constitutes a modern summary of TTE analysis concepts and methods. A curated list of references is provided.