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  • Competing-risks regression using stcrreg: How to check PH and appropriately use tvc for time-varying covariates

    Hi there,

    I am using competing risk analysis with stcrreg to estimate the risk of neutropenia related to exposure to a drug (valganciclovir) in solid organ transplant recipients. The competing risk is death. I initially did not treat valganciclovir as time-varying but I received some feedback that I should.

    My questions are:
    1. Can I use valganciclovir as binary and still assess it as time-varying or should I ideally treat it that variable as continuous (i.e., days) if treating it as time-varying? It is just that I don't expect a significant increase in the risk by one unit of time which is one day. I mostly want to compare the rates of this complication in patients that receive this drug regardless of duration versus those who don't.
    2.When I use the tvc command, should I should report the time variable SHRs in tvc only? I assume so as if I input it in both main and tvc, the only purpose would be to check the PH assumption. Is there any other way to check the PH assumption using stcrreg?
    Example:
    stcrreg age valgan ATG, compete(failure_var = 2) tvc(valgan) texp(ln(_t)) > Check PH
    stcrreg age ATG, compete(failure_var = 2) tvc(valgan) texp(ln(_t)) > The actual model SHRs that I will be reporting
    3. If I'm using stcrreg, do I also need to report cause-specific HRs using Cox? I am uncertain that this should always be done for competing risk regression.
    4. Since I have the time in survival time, I'm using the ln of time texp(ln(_t)). How do I know if I should multiply this by a certain factor?

    This was all based in https://www.stata.com/manuals/ststcrreg.pdf but wanted to make sure my interpretation is correct.

    Thanks,

    Sara
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