Simulate health state probabilities from a survival object using partitioned survival analysis.

# S3 method for survival
sim_stateprobs(x, ...)

Arguments

x

An object of class survival.

...

Further arguments passed to or from other methods.

Value

A stateprobs object.

Details

In an \(N\)-state partitioned survival model there are \(N-1\) survival curves and \(S_n(t)\) is the cumulative survival function denoting the probability of survival to health state \(n\) or a lower indexed state beyond time \(t\). The probability that a patient is in health state 1 at time \(t\) is simply \(S_1(t)\). State membership in health states \(2,\ldots, N -1\) is calculated as \(S_n(t) - S_{n-1}(t)\). Finally, the probability of being in the final health state \(N\) (i.e., the death state) is \(1-S_{N-1}(t)\), or one minus the overall survival curve.

In some cases, the survival curves may cross. hesim will issue a warning but the function will still run. Probabilities will be set to 0 in a health state if the prior survival curve lies above the curve for state \(n\); that is, if \(S_n(t) < S_{n-1}(t)\), then the probability of being in state \(n\) is set to 0 and \(S_n(t)\) is adjusted to equal \(S_{n-1}(t)\). The probability of being in the final health state is also adjusted if necessary to ensure that probabilities sum to 1.

See also

Examples

library("data.table") library("survival") # This example shows how to simulate a partitioned survival model by # manually constructing a "survival" object. We will consider a case in which # Cox proportional hazards models from the survival package---which are not # integrated with hesim---are used for parameter estimation. We will use # point estimates in the example, but bootstrapping, Bayesian modeling, # or other techniques could be used to draw samples for a probabilistic # sensitivity analysis. # (0) We first setup our model per usual by defining the treatment strategies, # target population, and health states hesim_dat <- hesim_data( strategies = data.table(strategy_id = 1:3, strategy_name = c("SOC", "New 1", "New 2")), patients = data.table(patient_id = 1:2, female = c(0, 1), grp_id = 1), states = data.table(state_id = 1:2, state_name = c("Stable", "Progression")) ) # (1) Next we will estimate Cox models with survival::coxph(). We illustrate # by predicting progression free survival (PFS) and overall survival (OS) ## Fit models onc3_pfs_os <- as_pfs_os(onc3, patient_vars = c("patient_id", "female", "strategy_name")) fit_pfs <- coxph(Surv(pfs_time, pfs_status) ~ strategy_name + female, data = onc3_pfs_os) fit_os <- coxph(Surv(os_time, pfs_status) ~ strategy_name + female, data = onc3_pfs_os) ## Predict survival on input data surv_input_data <- expand(hesim_dat) times <- seq(0, 14, 1/12) predict_survival <- function(object, newdata, times) { surv <- summary(survfit(object, newdata = newdata, se.fit = FALSE), t = times) pred <- newdata[rep(seq_len(nrow(newdata)), each = length(times)), ] pred[, sample := 1] # Point estimates only in this example pred[, time := rep(surv$time, times = nrow(newdata))] pred[, survival := c(surv$surv)] return(pred[, ]) } pfs <- predict_survival(fit_pfs, newdata = surv_input_data, times = times) os <- predict_survival(fit_os, newdata = surv_input_data, times = times) surv <- rbind( as.data.table(pfs)[, curve := 1L], as.data.table(os)[, curve := 2L] ) ## Convert predictions to a survival object surv <- survival(surv, t = "time") if (FALSE) autoplot(surv) # (2) We can then compute state probabilities from the survival object stprobs <- sim_stateprobs(surv) # (3) Finally, we can use the state probabilities to compute QALYs and costs ## A dummy utility model to illustrate utility_tbl <- stateval_tbl( data.table(state_id = 1:2, est = c(1, 1) ), dist = "fixed" ) utilitymod <- create_StateVals(utility_tbl, hesim_data = hesim_dat, n = 1) ## Instantiate Psm class and compute QALYs psm <- Psm$new(utility_model = utilitymod) psm$stateprobs_ <- stprobs psm$sim_qalys() psm$qalys_
#> sample strategy_id patient_id grp_id state_id dr qalys lys #> 1: 1 1 1 1 1 0.03 4.874007 4.874007 #> 2: 1 1 1 1 2 0.03 3.070008 3.070008 #> 3: 1 1 2 1 1 0.03 4.267061 4.267061 #> 4: 1 1 2 1 2 0.03 3.166468 3.166468 #> 5: 1 2 1 1 1 0.03 5.640397 5.640397 #> 6: 1 2 1 1 2 0.03 2.605955 2.605955 #> 7: 1 2 2 1 1 0.03 4.961563 4.961563 #> 8: 1 2 2 1 2 0.03 2.789254 2.789254 #> 9: 1 3 1 1 1 0.03 6.141992 6.141992 #> 10: 1 3 1 1 2 0.03 2.399936 2.399936 #> 11: 1 3 2 1 1 0.03 5.426923 5.426923 #> 12: 1 3 2 1 2 0.03 2.639381 2.639381