Dr. Therneau,
Thank you as always for first writing, and second continuing the Cox model in R 
(and earlier I believe in SAS).
 
While your comments concerning non-proportional hazards is helpful, it does not 
fully address the question, "What alternatives do I have if I assume 
proportional assumption of coxph does not hold?" The traditional answer would 
be, I believe, to define strata of a non proportional independent variable so 
that within strata the hazards are proportional, and then run the analyses 
accounting for the strata. While this will deal with a variable entered as a 
"nuisance" parameter, i.e. one that one wants to adjust for, but one that one 
is not interested in drawing inferences about, it does not solve the problem if 
the non-proportional covariate is one about which one wishes to make inferences 
as one does not get an estimate for a parameter used to define strata. Could 
you give some guidance about ways to deal with a non-proportional independent 
variable about which one does wish to make inferences?
Thank you,
John   


John David Sorkin M.D., Ph.D.
Professor of Medicine
Chief, Biostatistics and Informatics
University of Maryland School of Medicine Division of Gerontology
Baltimore VA Medical Center
10 North Greene Street
GRECC (BT/18/GR)
Baltimore, MD 21201-1524
(Phone) 410-605-7119
(Fax) 410-605-7913 (Please call phone number above prior to faxing) 
>>> Terry Therneau <thern...@mayo.edu> 08/13/13 9:14 AM >>>
That's the primary reason for the plot: so that you can look and think.

The test statistic is based on whether a LS line fit to the plot has zero 
slope. For 
larger data sets you can sometimes have a "significant" p-value but good 
agreement with 
proportional hazards. It's much like an example from Lincoln Moses' begining 
statistics 
book (now out of print, so rephrasing from memory).
 "Suppose that you flip a coin 10,000 times and get 5101 heads. What can you 
say?
 a. The coin is not perfectly fair (p<.05). b. But it is darn close to perfect! 
"
As a referee I would be comfortable using that coin to start a football game.

The Cox model gives an average hazard ratio, averaged over time. When 
proportional 
hazards holds that value is a complete summary-- nothing else is needed. When 
it does 
not hold, the average may still be useful, or not, depending on the degree of 
change over 
time.

Terry Therneau



On 08/13/2013 05:00 AM, r-help-requ...@r-project.org wrote:
> Thanks to Bert and G?ran for your responses.
>
> To answer G?ran's comment, yes I did plot the Schoenfeld residuals using
> plot.cox.zph and the lines look horizontal (slope = 0) to me, which makes
> me think that it contradicts the results of cox.zph.
>
> What alternatives do I have if I assume proportional assumption of coxph
> does not hold?
>
> Thanks!

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