Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2026 Feb;45(3-5):e70413.
doi: 10.1002/sim.70413.

Rforce: Random Forests for Composite Endpoints

Yu Wang  1 , Soyoung Kim  1 , Chien-Wei Lin  1 , Kwang Woo Ahn  1
Affiliations

Rforce: Random Forests for Composite Endpoints

Yu Wang et al. Stat Med. 2026 Feb.

Abstract

Medical research often involves the study of composite endpoints that combine multiple clinical events to assess the efficacy of treatments. When constructing composite endpoints, it is a common practice to analyze the time to the first event. However, this approach overlooks outcomes that occur after the first event, resulting in information loss. Furthermore, the terminal event can not only be of interest but also, be a competing risk for other types of outcomes. While existing semi-parametric regression models can be used to analyze both fatal (terminal) and non-fatal composite events, potential nonlinear covariate effects on the logarithm of the rate function have not been addressed. To address this important issue, we introduce random forests for composite endpoints (Rforce) consisting of non-fatal composite events and terminal events. Rforce utilizes generalized estimating equations to build trees and handles the dependent censoring due to the terminal events with the concept of pseudo-at-risk duration. Simulation studies and real data analysis are conducted to demonstrate the performance of Rforce.

Keywords: composite endpoints; proportional mean model; random forests.

PubMed Disclaimer

References

    1. J. Pidala, S. J. Lee, K. W. Ahn, et al., “Nonpermissive hla‐dpb1 Mismatch Increases Mortality After Myeloablative Unrelated Allogeneic Hematopoietic Cell Transplantation,” Blood 124, no. 16 (2014): 2596–2606, https://doi.org/10.1182/blood‐2014‐05‐576041.
    1. S. G. Holtan, T. E. DeFor, A. Lazaryan, et al., “Composite End Point of Graft‐Versus‐Host Disease‐Free, Relapse‐Free Survival After Allogeneic Hematopoietic Cell Transplantation,” Blood 125, no. 8 (2015): 1333–1338.
    1. D. R. Cox, “Regression Models and Life‐Tables,” Journal of the Royal Statistical Society. Series B, Statistical Methodology 34, no. 2 (1972): 187–202, https://doi.org/10.1111/j.2517‐6161.1972.tb00899.x.
    1. L. Mao and D. Lin, “Semiparametric Regression for the Weighted Composite Endpoint of Recurrent and Terminal Events,” Biostatistics 17, no. 2 (2016): 390–403.
    1. X. Sun, J. Ding, and L. Sun, “A Semiparametric Additive Rates Model for the Weighted Composite Endpoint of Recurrent and Terminal Events,” Lifetime Data Analysis 26 (2020): 471–492.