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Kaplan-Meier Curves in Excel

October 11, 2011 6:00 am Posted in statistics

Clinical studies often use Kaplan-Meier (aka survival) curves to show the proportion of patients that have survived after a certain period of time. There are a several articles that show you how to do the math: Bewick et al. Crit Care. 2004 Oct;8(5):389-94. Clark et al. Br J Cancer. 2003 Jul 21;89(2):232-8. Unfortunately, Excel does not include a function to graph Kaplan-Meier curves. You have to reformat the data to be able to create survival curves in Excel. Check out SCEW, an Excel add-in that allows you to create Kaplan-Meier curves. You do not have to download the add-in if youre willing to manually type in the spreadsheet formulas that reformat the data (see Appendix A). Once you have reformatted the data, you can use the scatter graph function to create the KaplanMeier curve. For your convenience, I have created an Excel spreadsheet on Scribd that you can use.

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Sample size, median survival time and survival proportion

In this example, the sample size was 21 cases in both groups. The median survival time was 23 units in group 1, and 8 units group 2. The median survival time is the time at which half the subjects have reached the event of interest. If the survival curve does not fall to 0.5 (50%) then the median time cannot be computed. Next the survival proportions (with standard error) are listed for all groups for each observed timepoint. When you scroll down (press the Page Down key), you see the result of the logrank test for the comparison between the two survival curves: In this example, 9 cases in group 1 and 21 cases in group 2 presented the outcome of interest. The chisquare statistic was 16.79 with associated P-value of less than 0.0001. The conclusion therefore is that, statistically, the two survival curves differ significantly, or that the grouping variable has a significant influence on survival time. Hazard ratio

If you compare two survival curves then MedCalc also calculates the hazard ratio with its 95% confidence interval (CI). Hazard is a measure of how rapidly the event of interest occurs. The hazard ratio compares the hazards in two groups. In the example the hazard ratio is 4.1786 so that the estimated relative risk of the event of interest occurring in group 2 is 4.1786 higher than in group 1. This hazard ratio is significant different from the value 1 (corresponding to equal hazards) since the confidence interval 1.9812 to 8.8132 does not include the value 1. Note that the computation of the hazard ratio assumes that the ratio is consistent over time, so therefore if the survival curves cross, the hazard ratio statistic should be ignored. Logrank test for trend If more than two survival curves are compared, and there is a natural ordering of the groups, then MedCalc can also perform the logrank test for trend. This tests the probability that there is a trend in survival scores across the groups. Literature Altman DG (1991) Practical statistics for medical research. London: Chapman and Hall. See also Cox proportional-hazards regression Format graph Graph legend Add graphical objects Reference lines