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Adjusted Survival Curves Improve Understanding of Multivariable Cox Model Results
Institution:1. Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN;2. Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, AZ;3. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN;4. Division of Rheumatology, Mayo Clinic, Rochester, MN
Abstract:Kaplan-Meier survival curves are the most common methods for unadjusted group comparison of outcomes in orthopedic research. However, they may be misleading due to an imbalance of confounders between patient groups. The Cox model is frequently used to adjust for confounders, but graphical display of adjusted survival curves is not commonly utilized. We describe the circumstances when adjusted survival curves are useful in orthopedic research, describe and use 2 different methods to obtain adjusted curves, and illustrate how they can improve understanding of the multivariable Cox model results. We further provide practical strategies for identifying the need for and performing adjusted survival curves. Please visit the following https://youtu.be/ys0hy2CiMCA for a video that explains the highlights of the paper in practical terms.
Keywords:survival analysis  total joint arthroplasty  survival curves  Cox model  confounding
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