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Re: Exact meaning of "rsquare" at end of summary(coxph)

To: lawrence-hunsicker@uiowa.edu, s-news@lists.biostat.wustl.edu
Subject: Re: Exact meaning of "rsquare" at end of summary(coxph)
From: Terry Therneau <therneau@mayo.edu>
Date: Mon, 5 Jan 2004 10:11:12 -0600 (CST)
Cc: Michael.Schemper@vm230.AKH-WIEN.AC.AT
Reply-to: Terry Therneau <therneau@mayo.edu>
  There are dozens of definitions for an R-square for a Cox model.  I really
liked the following paper

  Korn, Edward L.  , and  Simon, Richard   (1990), ``Measures of explained 
variation for survival data'', Statistics in Medicine,  9  , 487-503 
  
which highlights, for me, one of the main issues.  Say that we are following
patients with advanced lung cancer (a median survival of < 2 years), a
model has predicted 10 year survival for patient X, and the patient actually
lived 20 years.  Any physician would say that this was perfect prediction,
and most R-square statistics would say that it was very bad -- worse than
telling a 3 year survivor that he had only 6 months.
  What exactly R-squared SHOULD be for survival studies is a hard question.
  
  What is used in coxph is a moderately good measure proposed by Nagelkirke,
that also has the virtue of being easy to compute.  

  Michael Schemper has given, I think, the most thought to the issues and
has published several papers.  (He also points out that Nagelkirke's idea
appears earlier due to someone else -- I forget who).  To dig deeper I would
recommend looking at his work.

        Terry Therneau
        


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