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Biostatistics · Biostatistics Fundamentals

Biostatistics: Survival Analysis and Kaplan-Meier Curves

Survival analysis concepts including Kaplan-Meier curves, hazard ratios, and censoring, one concept per card.

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What does survival analysis study, broadly speaking?
The time until a specific event of interest occurs (such as death, relapse, or failure), not just whether the event occurred
What is the outcome variable typically called in survival analysis?
Time-to-event (or survival time)
What is censoring in survival analysis?
A situation where the exact event time for a subject is unknown because the event had not occurred (or was not observed) by the end of the observation period
What is right censoring, the most common type of censoring in clinical studies?
When a subject's follow-up ends (study ends, subject withdraws, or is lost to follow-up) before the event of interest occurs, so it is only known the event happened after that point
What is left censoring?
When the event of interest is known to have occurred before observation began, but the exact time is unknown
Why can subjects who are censored still be included in a survival analysis, unlike in a simple average time-to-event calculation?
Survival analysis methods use all the follow-up time each subject contributed, even if the event was never observed, rather than discarding censored subjects
What is a Kaplan-Meier curve?
A graph that estimates the probability of survival (or remaining event-free) over time, using a step function that drops at each observed event
What does each downward step in a Kaplan-Meier curve represent?
The occurrence of one or more events at that particular time point
Why does a Kaplan-Meier curve typically not drop at a censoring time?
Censored observations are marked (often with a tick mark) on the curve but do not themselves represent an event, so the curve does not step down at that point
What does the y-axis of a standard Kaplan-Meier curve represent?
The estimated proportion of subjects surviving (or remaining event-free) at each time point
What statistical test is commonly used to compare survival curves between two or more groups?
The log-rank test
What is the null hypothesis tested by the log-rank test?
That there is no difference in the survival distributions between the groups being compared
What is the hazard rate in survival analysis?
The instantaneous risk of experiencing the event at a given time, conditional on having survived event-free up to that time
What is a hazard ratio?
The ratio of the hazard rate in one group compared to another, summarizing the relative risk of the event over the entire follow-up period
What does a hazard ratio of 1 indicate when comparing two groups?
No difference in the risk (hazard) of the event between the two groups

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