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Effective sample size for the Kaplan-Meier estimator: a valuable measure of uncertainty?

Title: Effective sample size for the Kaplan-Meier estimator: a valuable measure of uncertainty?
Authors: Hackmann, T.; Thomassen, D.; Stiggelbout, A.M.; Cessie, S. le; Putter, H.; Wreede, L.C. de; Steyerberg, E.W.; 4D PICTURE Consortium
Source: The American Statistician
Publication Year: 2025
Collection: Leiden Repository (Leiden University)
Subject Terms: Kaplan-Meier; Risk communication; Sample size; Survival; Uncertainty
Description: Sample size is an essential indicator of the uncertainty in clinical research results. When studies present time-to-event outcomes with Kaplan-Meier curves, these are often accompanied by the remaining number of patients at risk in a table below the curve. The number at risk at time t informs about uncertainty of the hazard at t, rather than the uncertainty of the estimated survival probability until t,S(t). We aim to review the role of the effective sample size of S(t) to reflect the uncertainty in survival probability estimation. Effective sample size is defined as the size of a hypothetical sample with complete follow-up until time t, that would give the same variance as the variance of the Kaplan-Meier estimate S(t). We consider hypothetical scenarios and a publicly available dataset with patients treated for colon cancer. These illustrations support that effective sample size provides a readily interpretable measure of uncertainty for survival curves in the presence of censoring. We show that effective sample size can also quantify the loss of information when the reporting for an ongoing study is moved to an earlier time point. In conclusion, effective sample size is a valuable measure of uncertainty in survival analysis. ; Analysis and support of clinical decision making
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: https://hdl.handle.net/1887/4300127
DOI: 10.1080/00031305.2025.2542390
Availability: https://hdl.handle.net/1887/4300127; https://doi.org/10.1080/00031305.2025.2542390
Accession Number: edsbas.355C4E5F
Database: BASE