Comparisons of the performance of different statistical tests for time-to-event analysis with confounding factors: practical illustrations in kidney transplantation

Abstract

Confounding factors are commonly encountered in observational studies. Several confounder-adjusted tests to compare survival between differently exposed subjects were proposed. However, only few studies have compared their performances regarding type I error rates, and no study exists evaluating their type II error rates. In this paper, we performed a comparative simulation study based on two different applications in kidney transplantation research. Our results showed that the propensity score-based inverse probability weighting (IPW) log-rank test proposed by Xie and Liu (2005) can be recommended as a first descriptive approach as it provides adjusted survival curves and has acceptable type I and II error rates. Even better performance was observed for the Wald test of the parameter corresponding to the exposure variable in a multivariable-adjusted Cox model. This last result is of primary interest regarding the exponentially increasing use of propensity score-based methods in the literature.

Keywords: adjusted Kaplan-Meier estimator; adjusted log-rank test; inverse probability weighting; propensity score; simulation study; survival data.