Breaking Free from the Hazard Ratio: Embracing the Restricted Mean Survival Time in Clinical Trials.

Han, Larry · NEJM Evid · 2023

review · Level V

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Abstract

Clinicians consider the Cox proportional hazards model to be the default tool of choice for analyzing right-censored time-to-event outcomes in randomized clinical trials.<sup>1</sup> The Cox model estimates the ratio of the hazard of the outcome of interest (e.g., the time to death) between two treatment groups. The hazard is defined as the instantaneous probability of experiencing the event of interest in the next time interval among individuals who had not yet experienced the event. As a statistical measure, the hazard ratio can be difficult to interpret.

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