A Decision-Theoretic Method for Analyzing Crossing Survival Curves in Healthcare

Elie Appelbaum, Moshe Leshno, Eitan Prisman and Prisman, Eliezer, Z.

MPRA Paper from University Library of Munich, Germany

Abstract: The problem of crossing Kaplan-Meier curves has not been solved in the medical research literature to date. This paper integrates survival curve comparisons into decision theory, providing a theoretical framework and a solution to the problem of crossing Kaplan-Meier curves. The application of decision theory allows us to apply stochastic dominance concepts and risk preference attributes to compare treatments even when standard Kaplan-Meier curves cross. The paper shows that as additional risk preference attributes are adopted, Kaplan-Meier curves can be ranked under weaker restrictions, namely with higher orders of stochastic dominance. Consequently, even Kaplan-Meier curves that cross may be ranked. The method we present allows us to extract all possible information from survival functions; hence, superior treatments that cannot be identified using standard Kaplan-Meier curves may become identifiable. Our methodology is applied to two examples of published empirical medical studies. We show that treatments deemed non-comparable because their Kaplan-Meier curves intersect can be compared using our method.

Keywords: Survival Curve Analysis; Decision Theory; Risk Preference Modelling; Stochastic Dominance; Medical Treatment Comparison; Healthcare Data Interpretation (search for similar items in EconPapers)
JEL-codes: C18 C65 D81 I10 I12 I19 (search for similar items in EconPapers)
Date: 2025-03-20
New Economics Papers: this item is included in nep-hea
References: Add references at CitEc
Citations:

Downloads: (external link)
https://mpra.ub.uni-muenchen.de/124419/1/MPRA_paper_124419.pdf original version (application/pdf)
https://mpra.ub.uni-muenchen.de/124727/1/MPRA_paper_124727.pdf revised version (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:pra:mprapa:124419

Access Statistics for this paper

More papers in MPRA Paper from University Library of Munich, Germany Ludwigstraße 33, D-80539 Munich, Germany. Contact information at EDIRC.
Bibliographic data for series maintained by Joachim Winter ().