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This vignette covers the diagnostic and inferential tools surrounding hazard model fitting: exploratory covariate screening, bootstrap confidence intervals, decile-of-risk validation, and sensitivity analysis across covariate scenarios. These correspond to the lg.*, bs.*, and hs.* steps in the classic HAZARD analysis workflow.

1 Exploratory covariate screening

Before fitting the parametric hazard model, it is useful to screen candidate covariates with simple logistic models. This identifies transformations and functional forms that should enter the final model.

data(avc)
avc <- na.omit(avc)

# Candidate covariates
candidates <- c("age", "status", "mal", "com_iv", "inc_surg", "orifice")

Fit a univariable logistic regression for each covariate against the death indicator:

logit_fits <- lapply(candidates, function(var) {
  fmla <- as.formula(paste("dead ~", var))
  glm(fmla, data = avc, family = binomial())
})
names(logit_fits) <- candidates

# Which covariates are significant univariably?
p_values <- vapply(logit_fits, function(f) {
  coef(summary(f))[2, "Pr(>|z|)"]
}, numeric(1))

data.frame(covariate = names(p_values),
           p_value   = round(p_values, 4),
           row.names = NULL)
#>   covariate p_value
#> 1       age  0.0017
#> 2    status  0.0000
#> 3       mal  0.0006
#> 4    com_iv  0.0000
#> 5  inc_surg  0.0114
#> 6   orifice  0.0034
ggplot(avc, aes(age, dead)) +
  geom_jitter(height = 0.05, width = 0, alpha = 0.3, size = 1) +
  geom_smooth(method = "loess", se = TRUE, colour = "#0072B2",
              linewidth = 0.8) +
  labs(x = "Age at operation (months)", y = "Death (0/1)") +
  theme_minimal()
#> `geom_smooth()` using formula = 'y ~ x'
Figure 1: Exploratory: age vs. mortality with LOESS smooth

The LOESS smooth reveals the functional form of each covariate’s relationship to mortality, guiding decisions about transformations (log, polynomial) before the hazard model.

1.1 Quantile calibration with hzr_calibrate()

hzr_calibrate() bins a continuous covariate into quantile groups and applies the logit / Gompertz / Cox link transform, so you can eyeball whether the covariate-outcome relationship is linear on the chosen link scale. It corresponds to the SAS logit.sas / logitgr.sas macros.

age_cal <- hzr_calibrate(
  x      = avc$age,
  event  = avc$dead,
  groups = 10,
  link   = "logit"
)
print(age_cal)
#> Variable calibration (logit link, 10 groups)
#> 
#>  group  n events    mean     min     max  prob link_value
#>      1 30     11   3.519   1.051   5.388 0.367     -0.547
#>      2 31     11   8.665   5.421  11.532 0.355     -0.598
#>      3 30     13  15.194  11.631  18.497 0.433     -0.268
#>      4 31     11  23.077  18.990  27.828 0.355     -0.598
#>      5 30      7  43.544  28.124  57.167 0.233     -1.190
#>      6 31      3  72.066  59.730  86.408 0.097     -2.234
#>      7 30      2 101.154  86.507 117.522 0.067     -2.639
#>      8 31      3 162.739 121.169 203.733 0.097     -2.234
#>      9 30      4 247.051 205.343 297.140 0.133     -1.872
#>     10 31      3 530.623 324.573 790.981 0.097     -2.234

A roughly linear trend across groups means the logit link is appropriate; strong curvature flags the need for a transform (for example, polynomial or log).

2 Nonparametric baselines

Before fitting the parametric model, run a Kaplan-Meier or Nelson baseline. hzr_kaplan() returns KM with logit-transformed confidence limits (more accurate in the tails than Greenwood), along with interval hazard rate, density, and restricted mean survival time. hzr_nelson() returns the Wayne Nelson cumulative hazard estimator with lognormal confidence limits.

km <- hzr_kaplan(time = avc$int_dead, status = avc$dead, conf_level = 0.95)
print(km)
#> Kaplan-Meier estimate with logit confidence limits
#> Events: 68  | Time points: 44 
#> Survival range: 0 to 0.9836 
#> RMST at last event: 129.3468 
#> 
#>         time n_risk n_event n_censor survival std_err cl_lower cl_upper cumhaz
#>  0.001368954    305       5        0   0.9836  0.0073   0.9612   0.9932 0.0165
#>  0.002737907    300       2        0   0.9770  0.0086   0.9527   0.9890 0.0232
#>  0.008213721    298       2        0   0.9705  0.0097   0.9443   0.9846 0.0300
#>  0.016427440    296       5        0   0.9541  0.0120   0.9240   0.9726 0.0470
#>  0.032854880    291       3        0   0.9443  0.0131   0.9122   0.9651 0.0574
#>  0.049282330    288       1        0   0.9410  0.0135   0.9083   0.9625 0.0608
#>  0.053389190    287       1        0   0.9377  0.0138   0.9044   0.9599 0.0643
#>  0.054758140    286       1        0   0.9344  0.0142   0.9006   0.9573 0.0678
#>  0.065709770    285       5        0   0.9180  0.0157   0.8815   0.9440 0.0855
#>  0.071185580    280       1        0   0.9148  0.0160   0.8777   0.9413 0.0891
#>  0.082137210    279       2        0   0.9082  0.0165   0.8702   0.9359 0.0963
#>  0.098564650    277       2        0   0.9016  0.0171   0.8628   0.9304 0.1035
#>  0.114992100    275       3        0   0.8918  0.0178   0.8517   0.9221 0.1145
#>  0.131419500    272       1        0   0.8885  0.0180   0.8480   0.9193 0.1182
#>  0.229984200    270       2        0   0.8819  0.0185   0.8407   0.9136 0.1256
#>  0.262839100    268       1        1   0.8787  0.0187   0.8370   0.9108 0.1294
#>  0.279266500    266       1        0   0.8753  0.0189   0.8333   0.9080 0.1331
#>  0.328548800    264       2        0   0.8687  0.0194   0.8259   0.9022 0.1407
#>  0.344976300    262       1        0   0.8654  0.0196   0.8223   0.8993 0.1446
#>  0.377831200    261       1        0   0.8621  0.0198   0.8186   0.8965 0.1484
#>   hazard density   life
#>  12.0744 11.9752 0.0014
#>   4.8862  4.7901 0.0027
#>   1.2298  1.1975 0.0081
#>   2.0741  1.9959 0.0160
#>   0.6308  0.5988 0.0317
#>   0.2117  0.1996 0.0472
#>   0.8499  0.7983 0.0511
#>   2.5586  2.3950 0.0524
#>   1.6162  1.4969 0.0626
#>   0.6534  0.5988 0.0676
#>   0.6569  0.5988 0.0776
#>   0.4411  0.3992 0.0926
#>   0.6677  0.5988 0.1074
#>   0.2242  0.1996 0.1220
#>   0.2263  0.2003 0.2096
#>   0.1138  0.1002 0.2386
#>   0.2293  0.2011 0.2530
#>   0.2315  0.2018 0.2962
#>   0.2328  0.2018 0.3104
#>   0.1168  0.1009 0.3389
#> ... ( 24  more rows)
nel <- hzr_nelson(time = avc$int_dead, event = avc$dead, conf_level = 0.95)
print(nel)
#> Nelson cumulative hazard estimate with lognormal CL
#> Events: 68  | Time points: 44 
#> 
#>         time n_risk n_event weight_sum cumhaz std_err cl_lower cl_upper  hazard
#>  0.001368954    305       5          5 0.0164  0.0033   0.0109   0.0237 11.9752
#>  0.002737907    300       2          2 0.0231  0.0047   0.0153   0.0335  4.8699
#>  0.008213721    298       2          2 0.0298  0.0057   0.0201   0.0425  1.2256
#>  0.016427440    296       5          5 0.0467  0.0067   0.0350   0.0610  2.0565
#>  0.032854880    291       3          3 0.0570  0.0075   0.0437   0.0730  0.6276
#>  0.049282330    288       1          1 0.0604  0.0082   0.0459   0.0782  0.2114
#>  0.053389190    287       1          1 0.0639  0.0089   0.0482   0.0832  0.8484
#>  0.054758140    286       1          1 0.0674  0.0096   0.0506   0.0881  2.5541
#>  0.065709770    285       5          5 0.0850  0.0102   0.0667   0.1067  1.6019
#>  0.071185580    280       1          1 0.0885  0.0108   0.0692   0.1116  0.6522
#>  0.082137210    279       2          2 0.0957  0.0114   0.0753   0.1199  0.6546
#>  0.098564650    277       2          2 0.1029  0.0119   0.0815   0.1282  0.4395
#>  0.114992100    275       3          3 0.1138  0.0125   0.0913   0.1402  0.6641
#>  0.131419500    272       1          1 0.1175  0.0130   0.0941   0.1450  0.2238
#>  0.229984200    270       2          2 0.1249  0.0135   0.1006   0.1534  0.0752
#>  0.262839100    268       1          1 0.1287  0.0140   0.1034   0.1582  0.1136
#>  0.279266500    266       1          1 0.1324  0.0145   0.1063   0.1629  0.2288
#>  0.328548800    264       2          2 0.1400  0.0149   0.1130   0.1715  0.1537
#>  0.344976300    262       1          1 0.1438  0.0154   0.1160   0.1763  0.2323
#>  0.377831200    261       1          1 0.1476  0.0158   0.1190   0.1811  0.1166
#>  cum_events
#>           5
#>           7
#>           9
#>          14
#>          17
#>          18
#>          19
#>          20
#>          25
#>          26
#>          28
#>          30
#>          33
#>          34
#>          36
#>          37
#>          38
#>          40
#>          41
#>          42
#> ... ( 24  more rows)

3 Bootstrap confidence intervals

Bootstrap resampling is the primary uncertainty quantification method in the HAZARD workflow. Each replicate refits the model on a resampled dataset and accumulates prediction curves; the CI is summarized across replicates.

# Fit the base model that bootstrapping will use
fit <- hazard(
  Surv(int_dead, dead) ~ age + status + mal + com_iv,
  data  = avc,
  dist  = "weibull",
  theta = c(mu = 0.20, nu = 1.0, rep(0, 4)),
  fit   = TRUE,
  control = list(maxit = 500)
)

# Prediction grid at a median-risk profile
t_grid <- seq(0.01, max(avc$int_dead) * 0.9, length.out = 100)
base_nd <- data.frame(time = t_grid, age = median(avc$age),
                      status = 2, mal = 0, com_iv = 0)

surv_point <- predict(fit, newdata = base_nd, type = "survival")

hzr_bootstrap() wraps the resample-and-refit loop: it returns a long data frame of per-replicate coefficient estimates ($replicates) and a parameter-level summary (mean, SD, 95 % percentile CI) in $summary. It corresponds to the SAS bootstrap.hazard.sas and bootstrap.summary.sas macros.

set.seed(42)
boot <- hzr_bootstrap(fit, n_boot = 30)  # kept small for vignette build time
print(boot)
#> Bootstrap inference for hazard model
#> Replicates: 30 successful, 0 failed
#> 
#>  parameter  n pct    mean     sd     min    max ci_lower ci_upper
#>         mu 30 100  0.0000 0.0000  0.0000 0.0000   0.0000   0.0000
#>         nu 30 100  0.2174 0.0603  0.0004 0.2668   0.0012   0.2587
#>        age 30 100 -0.0025 0.0024 -0.0100 0.0026  -0.0079   0.0011
#>     status 30 100  0.6778 0.1666  0.2712 1.0751   0.3792   0.9582
#>        mal 30 100  0.4165 0.3526 -0.4065 0.9703  -0.3595   0.9447
#>     com_iv 30 100  0.9099 0.4358  0.0609 2.0954   0.2661   2.0265

The parameter-level CIs above come directly from the bootstrap distribution. Prediction-level CIs (on the survival curve or hazard profile) require pivoting boot$replicates to wide format and evaluating the parametric survival formula once per replicate. That workflow is out of scope for this section, but the building blocks are all in the returned object.

4 Goodness-of-fit overlay

hzr_gof() computes parametric predictions against the nonparametric Kaplan-Meier estimator and the Conservation-of-Events observed-vs- expected event counts. It corresponds to the SAS hazplot.sas macro.

gof <- hzr_gof(fit)
print(gof)
#> Goodness-of-fit: observed vs. expected events
#> Distribution: weibull  | n = 305 
#> 
#> Total observed events: 68 
#> Total expected events: 50.433 
#> Final residual (E - O): -17.567 
#> Conservation ratio (E/O): 0.742 
#> 
#> Use plot columns: time, km_surv, par_surv, cum_observed, cum_expected, residual

The observed vs. expected ratio (printed at the bottom) is the Conservation-of-Events check: a well-specified model recovers the event count exactly, so a ratio close to 1 is what we want. Ratios well above or below 1 flag either a misspecified shape or a covariate that isn’t really linear on the log-hazard scale.

5 Decile-of-risk calibration

hzr_deciles() partitions patients into deciles of predicted risk at a chosen time point and compares observed with expected event counts decile-by-decile, returning a chi-square goodness-of-fit test. It corresponds to the SAS deciles.hazard.sas macro.

deciles <- hzr_deciles(fit, time = 120, groups = 10)
print(deciles)
#> Decile-of-risk calibration at time = 120 
#> Included 86 observations (excluded 219 censored before horizon).
#> 10 groups, 66 observed events, 33.7 expected
#> 
#>  group n events expected observed_rate expected_rate chi_sq  p_value
#>      1 8      1    0.458         0.125        0.0573  0.641 0.424000
#>      2 9      2    0.973         0.222        0.1080  1.080 0.298000
#>      3 8      5    1.410         0.625        0.1760  9.170 0.002460
#>      4 9      7    2.310         0.778        0.2570  9.530 0.002030
#>      5 9      9    2.890         1.000        0.3210 12.900 0.000321
#>      6 8      7    3.300         0.875        0.4120  4.160 0.041400
#>      7 9      9    4.200         1.000        0.4670  5.480 0.019200
#>      8 8      8    4.300         1.000        0.5380  3.180 0.074700
#>      9 9      9    6.140         1.000        0.6820  1.330 0.249000
#>     10 9      9    7.690         1.000        0.8540  0.224 0.636000
#>  mean_survival mean_cumhaz
#>          0.943      0.0591
#>          0.892      0.1150
#>          0.824      0.1940
#>          0.743      0.2970
#>          0.679      0.3870
#>          0.588      0.5320
#>          0.533      0.6300
#>          0.462      0.7720
#>          0.318      1.1700
#>          0.146      2.0100
#> 
#> Overall: chi-sq = 47.7 on 9 df, p = 2.86e-07

The chi-square test statistic and p-value summarise whether the observed decile-by-decile event counts are consistent with what the parametric model predicts. A good visual check is to plot the two columns side by side:

decile_df <- as.data.frame(deciles)
cal_long <- rbind(
  data.frame(group = decile_df$group,
             rate  = decile_df$observed_rate,
             Series = "Observed"),
  data.frame(group = decile_df$group,
             rate  = decile_df$expected_rate,
             Series = "Expected")
)
ggplot(cal_long, aes(group, rate, fill = Series)) +
  geom_col(position = position_dodge(width = 0.7), alpha = 0.8) +
  scale_fill_manual(values = c("Observed" = "#56B4E9",
                                "Expected" = "#E69F00")) +
  scale_x_continuous(breaks = seq_len(nrow(decile_df))) +
  scale_y_continuous(labels = scales::percent_format(accuracy = 1)) +
  labs(x = "Risk decile (1 = lowest)", y = "Mortality rate", fill = NULL) +
  theme_minimal() +
  theme(legend.position = "bottom")
Figure 2: Observed vs. expected mortality by decile of risk

6 Sensitivity analysis

Sensitivity analysis compares predictions across different covariate configurations to assess how the model responds to risk factor changes.

# Define reference and high-risk profiles
ref_profile <- data.frame(
  age    = median(avc$age),
  status = 2,
  mal    = 0,
  com_iv = 0
)

high_risk <- data.frame(
  age    = quantile(avc$age, 0.90),
  status = 4,
  mal    = 1,
  com_iv = 1
)
sens_curves <- do.call(rbind, lapply(
  list("Reference" = ref_profile, "High risk" = high_risk),
  function(p) {
    nd <- p[rep(1, length(t_grid)), ]
    nd$time <- t_grid
    data.frame(time = t_grid,
               survival = predict(fit, newdata = nd, type = "survival") * 100,
               Profile = deparse(substitute(p)))
  }
))
# Fix profile labels
sens_curves$Profile <- rep(c("Reference", "High risk"),
                           each = length(t_grid))
sens_curves$Profile <- factor(sens_curves$Profile,
                              levels = c("Reference", "High risk"))

ggplot(sens_curves, aes(time, survival, colour = Profile)) +
  geom_line(linewidth = 0.9) +
  scale_colour_manual(values = c("Reference" = "#009E73",
                                 "High risk" = "#D55E00")) +
  scale_y_continuous(limits = c(0, 100)) +
  labs(x = "Months after AVC repair", y = "Freedom from death (%)",
       colour = NULL) +
  theme_minimal() +
  theme(legend.position = "bottom")
Figure 3: Sensitivity analysis: reference vs. high-risk profile

The gap between the curves quantifies the clinical impact of the risk factors. The sensitivity analysis is most informative when combined with bootstrap confidence intervals on each curve, showing whether the difference is statistically meaningful.

7 Analysis workflow summary

The complete HAZARD analysis sequence, now implemented in TemporalHazard:

  1. Exploratory screening (glm, hzr_calibrate()) — identify covariate transformations and functional forms
  2. Nonparametric baselines (hzr_kaplan(), hzr_nelson()) — reference KM / Nelson cumulative hazard estimators
  3. Fit hazard model (hazard()) — parametric shape + covariates
  4. Predict & visualize (predict()) — survival, hazard, risk profiles
  5. Goodness-of-fit overlay (hzr_gof()) — parametric vs. KM + Conservation-of-Events check
  6. Bootstrap CIs (hzr_bootstrap()) — uncertainty quantification via resampling
  7. Sensitivity analysis (predict() on covariate profiles) — compare scenarios across risk factors
  8. Decile calibration (hzr_deciles()) — chi-square observed vs. expected by risk decile

See vignette("getting-started") for the minimal workflow and vignette("fitting-hazard-models") for the model-fitting details.