The identification of similar patient pathways is a crucial task in healthcare analytics. A flexible tool to address this issue are parametric competing risks models, where transition intensities may be specified by a variety of parametric distributions, thus in particular being possibly time-dependent. We assess the similarity between two such models by examining the transitions between different health states. This research introduces a method to measure the maximum differences in transition intensities over time, leading to the development of a test procedure for assessing similarity. We propose a parametric bootstrap approach for this purpose and provide a proof to confirm the validity of this procedure. The performance of our proposed method is evaluated through a simulation study, considering a range of sample sizes, differing amounts of censoring, and various thresholds for similarity. Finally, we demonstrate the practical application of our approach with a case study from urological clinical routine practice, which inspired this research.
Keywords: bootstrap; multistate models; parametric competing risks models; routine clinical data; similarity; small data.
© 2024 The Author(s). Statistics in Medicine published by John Wiley & Sons Ltd.