The Kaplan–Meier estimator, also known as the product limit estimator, is a non-parametric statistic used to estimate the survival function from lifetime data. In medical research, it is often used to measure the fraction of patients living for a certain amount of time after treatment. In other fields, Kaplan–Meier estimators may be used to measure the length of time people remain unemployed after a job loss, the time-to-failure of machine parts, or how long fleshy fruits remain on plants before they are removed by frugivores. The estimator is named after Edward L. Kaplan and Paul Meier, who each submitted similar manuscripts to the Journal of the American Statistical Association. The journal editor, John Tukey, convinced them to combine their work into one paper, which has been cited about 34,000 times since its publication.
A plot of the Kaplan–Meier estimator is a series of declining horizontal steps which, with a large enough sample size, approaches the true survival function for that population. The value of the survival function between successive distinct sampled observations ("clicks") is assumed to be constant.
An important advantage of the Kaplan–Meier curve is that the method can take into account some types of censored data, particularly right-censoring, which occurs if a patient withdraws from a study, is lost to follow-up, or is alive without event occurrence at last follow-up. On the plot, small vertical tick-marks indicate individual patients whose survival times have been right-censored. When no truncation or censoring occurs, the Kaplan–Meier curve is the complement of the empirical distribution function.
In medical statistics, a typical application might involve grouping patients into categories, for instance, those with Gene A profile and those with Gene B profile. In the graph, patients with Gene B die much more quickly than those with gene A. After two years, about 80% of the Gene A patients survive, but less than half of patients with Gene B.
In order to generate a Kaplan–Meier estimator, at least two pieces of data are required for each patient (or each subject): the status at last observation (event occurrence or right-censored) and the time to event (or time to censoring). If the survival functions between two or more groups are to be compared, then a third piece of data is required: the group assignment of each subject.
Benefits and limitations
The Kaplan–Meier estimator is one of the most frequently used methods of survival analysis. The estimate may be useful to examine recovery rates, the probability of death, and the effectiveness of treatment. It is limited in its ability to estimate survival adjusted for covariates; parametric survival models and the Cox Proportional hazards model may be useful to estimate covariate-adjusted survival.
In some cases, one may wish to compare different Kaplan–Meier curves. This may be done by several methods including:
- SAS: The Kaplan–Meier estimator is implemented in the
- R: the Kaplan–Meier estimator is available as part of the
- Stata: the command
stsreturns the Kaplan–Meier estimator.
- Python: the
lifelinespackage includes the Kaplan–Meier estimator.
- MATLAB: the
ecdffunction with the
'function','survivor'arguments can calculate or plot the Kaplan–Meier estimator.
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