Flexible survival regression modelling

Stat Methods Med Res. 2010 Feb;19(1):5-28. doi: 10.1177/0962280209105022. Epub 2009 Jul 16.


Regression analysis of survival data, and more generally event history data, is typically based on Cox's regression model. We here review some recent methodology, focusing on the limitations of Cox's regression model. The key limitation is that the model is not well suited to represent time-varying effects. We start by considering classical and also more recent goodness-of-fit procedures for the Cox model that will reveal when the Cox model does not capture important aspects of the data, such as time-varying effects. We present recent regression models that are able to deal with and describe such time-varying effects. The introduced models are all applied to data on breast cancer from the Norwegian cancer registry, and these analyses clearly reveal the shortcomings of Cox's regression model and the need for other supplementary analyses with models such as those we present here.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Breast Neoplasms / mortality
  • Female
  • Humans
  • Norway / epidemiology
  • Proportional Hazards Models
  • Regression Analysis*
  • Statistics, Nonparametric
  • Survival Analysis*
  • Time Factors