English

The population-attributable fraction for time-dependent exposures and competing risks - A discussion on estimands

Applications 2019-08-22 v1 Methodology

Abstract

The population-attributable fraction (PAF) quantifies the public health impact of a harmful exposure. Despite being a measure of significant importance an estimand accommodating complicated time-to-event data is not clearly defined. We discuss current estimands of the PAF used to quantify the public health impact of an internal time-dependent exposure for data subject to competing outcomes. To overcome some limitations, we proposed a novel estimand which is based on dynamic prediction by landmarking. In a profound simulation study, we discuss interpretation and performance of the various estimands and their estimators. The methods are applied to a large French database to estimate the health impact of ventilator-associated pneumonia for patients in intensive care.

Keywords

Cite

@article{arxiv.1904.08692,
  title  = {The population-attributable fraction for time-dependent exposures and competing risks - A discussion on estimands},
  author = {Maja von Cube and Martin Schumacher and Sebastien Bailly and Jean-Francois Timsit and Alain Lepape and Anne Savey and Anais Machut and Martin Wolkewitz},
  journal= {arXiv preprint arXiv:1904.08692},
  year   = {2019}
}

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