Random Effect Restricted Mean Survival Time Model

Abstract: The restricted mean survival time (RMST) model has been garnering attention as a way to provide a clinically intuitive measure: the mean survival time. RMST models, which use methods based on pseudo time-to-event values and inverse probability censoring weighting, can adjust covariates. However, no approach has yet been introduced that considers random effects for clusters. In this paper, we propose a new random-effect RMST. We present two methods of analysis that consider variable effects by i) using a generalized mixed model with pseudo-values and ii) integrating the estimated results from the inverse probability censoring weighting estimating equations for each cluster. We evaluate our proposed methods through computer simulations. In addition, we analyze the effect of a mother's age at birth on under-five deaths in India using states as clusters.