Given the limitations of using the Cox hazard ratio to summarize the magnitude of the treatment effect, alternative measures that do not have these limitations are gaining attention. One of the recently proposed alternative methods uses the average hazard with survival weight (AH). This population quantity can be interpreted as the average intensity of the event occurrence in a given time window that does not involve study-specific censoring. Inference procedures for the ratio of AH and difference in AH have already been proposed in simple randomized controlled trial settings to compare two groups. However, methods with stratification factors have not been well discussed, although stratified analysis is often used in practice to adjust for confounding factors and increase the power to detect a between-group difference. The conventional stratified analysis or meta-analysis approach, which integrates stratum-specific treatment effects using an optimal weight, directly applies to the ratio of AH and difference in AH. However, this conventional approach has significant limitations similar to the Cochran-Mantel-Haenszel method for a binary outcome and the stratified Cox procedure for a time-to-event outcome. To address this, we propose a new stratified analysis method for AH using standardization. With the proposed method, one can summarize the between-group treatment effect in both absolute difference and relative terms, adjusting for stratification factors. This can be a valuable alternative to the traditional stratified Cox procedure to estimate and report the magnitude of the treatment effect on time-to-event outcomes using hazard.

翻译：鉴于使用Cox风险比概括处理效应大小存在局限性，不具此类局限性的替代测量方法正逐渐受到关注。近期提出的一种替代方法采用"生存权重平均风险"(AH)指标——该总体量可解释为在给定时间窗口内事件发生平均强度，且不受特定研究删失机制影响。尽管针对AH比值与AH差值的推断程序已在简单随机对照试验中提出以比较两组差异，但含分层因素的分析方法尚未得到充分讨论，而实践中常通过分层分析调整混杂因素并增强组间差异检测效能。传统分层分析或荟萃分析方法采用最优权重整合各层特异性处理效应，可直接应用于AH比值与AH差值分析。然而，该方法存在类似二分结局Cochran-Mantel-Haenszel法及事件时间终点分层Cox过程的显著局限性。为此，我们提出基于标准化原理的AH新型分层分析方法。该方法可通过绝对差值与相对比值两种形式概括组间处理效应，同时调整分层因素。作为传统分层Cox过程的有力替代方案，本研究方法可基于风险函数对事件时间终点的处理效应大小进行估计与报告。