ANALISIS SURVIVAL:

KAPLAN MEIER

OLEH

ZULAELA

PRODI STATISTIKA FAKULTAS MATEMATIKA DAN ILMU PENGETAHUAN ALAM

CLINICAL EPIDEMIOLOGY & BIOSTATISTICS UNIT (CE&BU), FAKULTAS KEDOKTERAN
UNIVERSITAS GADJAH MADA
ANALISIS SURVIVAL:
 Apa itu analisis survival?
suatu analisis data yang variabel outcomenya
waktu sampai munculnya kejadian (time until
an event occures).

 Bedanya dengan analisis statistik lainnya:

Regresi linear: variabel outcome (skala
rasio/ kontinu)
measure of effect: regression
coefficient β
Follow up time info not used
 Bedanya dengan analisis statistik lainnya:
Regresi logistik: variabel outcome (skala
nominal/ dikotom)
measure of effect:
odds ratio OR = 𝑒 𝛽

Follow up time info not used

ANALISIS SURVIVAL
 Outcome variable: time until an event occurs
 Start follow up time event
 Time: years, months, days (from the beginning of
follow up of an individual until an event occurs)
 Event: death, disease incidence, relapse from
remission, recovery (return to work)

Time survival time (time that an individual

has survived over some follow up period
Event failure
CONTOH

 A 13 year follow up of an elderly population (60+) to see

how long subjects remain alive

the event of interest: death

the outcome: time in years until death

 How long patients survive after receiving a heart

transplant

the event of interest: death

the outcome: time until death (in months from

receiving a transplant
CENSORED DATA:
 Censoring terjadi ketika kita mengetaui/
mendapatkan informasi tentang individual survival
time (but we do not know survival time exactly)

 Censoring may occur, when:

a person does not experience the event before
the study ends (the study ends no event)
a person is lost to follow up during the study
period
a person withdraws from the study because
adverse drug reaction
Person Survival Time Failed / Event occur (1);
censored (0)
A 5 1
B 12 0
C 3,5 0
D 8 0
E 6 0
F 3,5 1
 Kaplan Meier Estimate
Angka yang berada dalam tabel berikut berasal dari
data hypothetical study bagi 10 pasien. Hasil
pengamatan menyatakan waktu dalam hari, dari
treatment to death. Lima pasien meninggal dan 5
lainnya tersensor. Konstruksikan estimasi the
survival curve utk populasi studi.

1*, 3, 4*, 5, 5, 6*, 7, 7, 7*, 8*

Tanda * menunjukkan censored survival time

 1*, 3, 4*, 5, 5, 6*, 7, 7, 7*, 8*

Tabel: Kaplan Meier Survival Curve

t r n pc P(T > t) s.e.

0 0 10 1.0 1.0 -
3 1 9 0.89 0.89 0.10
5 2 7 0.71 0.64 0.15
7 2 4 0.50 0.32 0.13
8 1 1 0.00 0.00 -

t observed distinct survival times, in days

r the number of deaths recorded at t days
n the number of individuals still under observation at t days
pc the proportion of individuals under observation at t days who
do not die at t days = (n-r)/n
P(T > t) the estimated probability of survival beyond t days
s.e. the approximate standard error for the estimated probability
of survival beyond t days
 Survival Table
Time Status Cumulative Proportion N of N of
Surviving at the Time Cumulative Remaining
Estimate Std. Error Events Cases
1 1.000 censored . . 0 9
2 3.000 death .889 .105 1 8
3 4.000 censored . . 1 7
4 5.000 death . . 2 6
5 5.000 death .635 .169 3 5
6 6.000 censored . . 3 4
7 7.000 death . . 4 3
8 7.000 death .317 .180 5 2
9 7.000 censored . . 5 1
10 8.000 censored . . 5 0
Contoh: Log Rank Test

Angka dalam tabel berikut menunjukkan survival times in days,

untuk membandingkan mortalitas antar dua kelompok:
____________________________________________________

Kelompok 1: 1*, 3, 4*, 5, 5, 6*, 7, 7, 7*, 8

Kelompok 2: 2, 2, 3*, 4, 6*, 6*, 7, 10

____________________________________________________

* menunjukkan observasi yang tersensor.

 Survival Analysis for TIME follow up in days

Factor GROUP = kelompok 1

Time Status Cumulative Standard Cumulative Number

Survival Error Events Remaining
1.00 alive 0 9
3.00 died .8889 .1048 1 8
4.00 alive 1 7
5.00 died 2 6
5.00 died .6349 .1692 3 5
6.00 alive 3 4
7.00 died 4 3
7.00 died .3175 .1799 5 2
7.00 alive 5 1
8.00 died .0000 .0000 6 0

Number of Cases: 10 Censored: 4 ( 40.00%) Events: 6

Survival Time Standard Error 95% Confidence Interval

Mean: 6.37 .63 ( 5.14, 7.59 )
Median: 7.00 1.13 ( 4.78, 9.22 )
 Survival Analysis for TIME follow up in days

Factor GROUP = kelompok 2

Time Status Cumulative Standard Cumulative Number

Survival Error Events Remaining

2.00 died 1 7
2.00 died .7500 .1531 2 6
3.00 alive 2 5
4.00 died .6000 .1817 3 4
6.00 alive 3 3
6.00 alive 3 2
7.00 died .3000 .2308 4 1
10.00 died .0000 .0000 5 0

Number of Cases: 8 Censored: 3 ( 37.50%) Events: 5

Survival Time Standard Error 95% Confidence Interval

Mean: 6.20 1.37 ( 3.51, 8.89 )

Median: 7.00 2.31 ( 2.48, 11.52 )
Survival Analysis for TIME follow up in days
Total Number Number Percent
Events Censored Censored

GROUP kelompok 1 10 6 4 40.00

GROUP kelompok 2 8 5 3 37.50

Overall 18 11 7 38.89

Test Statistics for Equality of Survival Distributions for GROUP

Statistic df Significance

Log Rank .00 1 .9736

 Survival F unctions
1.2

1.0

.8

.6

.4 k elompok

kelompok 2
.2

ke lompok 2-censored
0.0
kelompok 1

-.2 ke lompok 1-censored

0 2 4 6 8 10 12

follo w up in day s