Journal of clinical epidemiology
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To compare three ad hoc methods to estimate the marginal hazard of incident cancer acquired immune deficiency syndrome (AIDS) in a highly active antiretroviral therapy (1996-2006) relative to a monotherapy/combination therapy (1990-1996) calendar period, accounting for other AIDS events and deaths as competing risks. ⋯ When competing risks are independent of the event of interest, only method 1 produced unbiased estimates of the marginal HR, although independence cannot be verified from the data. When competing risks are dependent, method 1 generally produced the least-biased estimates of the marginal HR for the scenarios explored; however, alternative methods may be preferred.
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Triage systems, developed by consensus of experts and based on decision rules, are typically not validated. The objective is to discuss the challenges to evaluate the reliability and validity of triage systems. ⋯ Triage should be viewed as diagnostic research and would benefit if it would use the available methodology in diagnostic research.