TY - JOUR
T1 - Actuarial versus actual risk of porcine structural valve deterioration
AU - Grunkemeier, G. L.
AU - Jamieson, W. R.E.
AU - Miller, D. C.
AU - Starr, A.
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 1994
Y1 - 1994
N2 - Actuarial analysis, using nonparametric (e.g., life table or Kaplan- Meier) or parametric (statistical modeling) methods, is used to describe and compare survival probabilities by allowing for partial survival times (censoring). Although devised to describe freedom from death, this method has been extended to nonfatal complications, such as freedom from tissue valve failure. However, the risk described for nonfatal events is that which a patient would experience provided he were immortal. And patients with valve disease have a relatively high risk of dying, generating the question: 'What is the chance the valve will fail before the patient dies?' To answer this more practical (for individual patient management and population resource allocation) question requires an estimate of what we call actual failure, that is, the percentage of patients whose valve will actually fail before they die. This risk is less than the risk which the usual actuarial curve describes. This difference increases with patient age, because older patients have a lower risk of tissue failure and a higher risk of death than younger patients.
AB - Actuarial analysis, using nonparametric (e.g., life table or Kaplan- Meier) or parametric (statistical modeling) methods, is used to describe and compare survival probabilities by allowing for partial survival times (censoring). Although devised to describe freedom from death, this method has been extended to nonfatal complications, such as freedom from tissue valve failure. However, the risk described for nonfatal events is that which a patient would experience provided he were immortal. And patients with valve disease have a relatively high risk of dying, generating the question: 'What is the chance the valve will fail before the patient dies?' To answer this more practical (for individual patient management and population resource allocation) question requires an estimate of what we call actual failure, that is, the percentage of patients whose valve will actually fail before they die. This risk is less than the risk which the usual actuarial curve describes. This difference increases with patient age, because older patients have a lower risk of tissue failure and a higher risk of death than younger patients.
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U2 - 10.1016/s0022-5223(94)70298-5
DO - 10.1016/s0022-5223(94)70298-5
M3 - Article
C2 - 7934107
AN - SCOPUS:0028020898
VL - 108
SP - 709
EP - 718
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 4
ER -