Evidence mapPaperPMID 40319248Full record

ArticleBMC medical research methodology2025

Multi-group global tests for restricted mean survival time and restricted mean time lost: a variable transformation approach.

Shuyu Chen, Mengyao Wang, Xingyou Zhou, Wenbin Zhang, Chengfeng Zhang, Zheng Chen

Abstract read
In one paragraph

Article in BMC medical research methodology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Shuyu ChenDepartment of Biostatistics, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, No. 1023, South Shatai Road, Guangzhou, China.
Mengyao WangDepartment of Biostatistics, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, No. 1023, South Shatai Road, Guangzhou, China.
Xingyou ZhouDepartment of Biostatistics, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, No. 1023, South Shatai Road, Guangzhou, China.
Wenbin ZhangDepartment of Biostatistics, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, No. 1023, South Shatai Road, Guangzhou, China.
Chengfeng ZhangDepartment of Biostatistics, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, No. 1023, South Shatai Road, Guangzhou, China.
Zheng ChenDepartment of Biostatistics, School of Public Health (Guangdong Provincial Key Laboratory of Tropical Disease Research), Southern Medical University, No. 1023, South Shatai Road, Guangzhou, China. zheng-chen@hotmail.com.

Funding

Guangdong Basic and Applied Basic Research Foundation 2024A1515011402 and 2022A1515011525National Natural Science Foundation of China 82473723 and 82173622
6 · The paper itself

Abstract

backgroundRestricted mean survival time (RMST) quantifies survival benefits in single-endpoint analysis, while restricted mean time lost (RMTL) measures event-related time loss in competing risks settings. Both provide clinically intuitive interpretations of treatment effects without relying on proportional hazards assumptions or parametric distributions. While existing RMST/RMTL methods focus primarily on two-group comparisons, multi-arm trials are common in practice. However, asymptotic approaches for these metrics suffer from inflated type I error in small samples, limiting their reliability.

methodsWe propose a global test framework using variable transformation methods (e.g., log, clog-log, arcsine square root, logit), which is applicable to multi-group comparisons of RMST and extends to RMTL in the presence of competing risks. Monte-Carlo simulations were conducted to evaluate type I error and power under various scenarios, and two illustrative examples were provided.

resultsSimulations demonstrated that transformed RMST and RMTL global tests effectively controlled type I error across small samples and high censoring rates, while improving power compared to untransformed methods. For single-endpoint analysis, the RMST arcsine square root transformation is recommended. In competing risks settings, RMTL logit transformation is preferred when the event of interest occurs more frequently than competing events, whereas clog-log transformation performs better when competing events dominate.

conclusionsThe proposed transformation-based global tests offer researchers a flexible, assumption-free tool to compare treatment effects across multiple groups with enhanced reliability and interpretability. Additionally, an R package "compRM" was developed to implement the proposed methods.

Indexed as

Computer SimulationSurvival AnalysisData Interpretation, StatisticalHumansModels, StatisticalMonte Carlo MethodReproducibility of ResultsTime FactorsGlobal testRestricted mean survival timeRestricted mean time lostSurvival analysisVariable transformation

Identifiers

PMID40319248
PMCPMC12048978

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.