Statistics in Medicine

Accounting for bias due to a non‐ignorable tracing mechanism in a retrospective breast cancer cohort study

Journal Article


We consider the analysis of competing risks in a retrospective breast cancer cohort study where tracing of patients is dependent on survival to a pre‐specified truncation time. We demonstrate that if ignored, the observed cause‐specific hazards will become distorted before the truncation time. Two approaches to account for the tracing bias are considered. First, a likelihood‐based method using piecewise constant transition intensities under a Markov assumption. Second, a pseudo‐likelihood method using inverse probability of tracing weights. For the breast cancer example, both methods improve the precision of estimates compared with a conventional approach based on excluding patients. Copyright © 2010 John Wiley & Sons, Ltd.

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