TY - JOUR T1 - Hazard ratio funnel plots for survival comparisons JF - Journal of Epidemiology and Community Health JO - J Epidemiol Community Health SP - 856 LP - 861 DO - 10.1136/jech.2008.075069 VL - 63 IS - 10 AU - P Silcocks Y1 - 2009/10/01 UR - http://jech.bmj.com/content/63/10/856.abstract N2 - Background: Funnel plots are a form of control chart that give a snapshot of many institutions at a particular moment in time. This paper describes how funnel plots may be constructed for survival analyses based on hazard ratios obtained from a Cox regression model with adjustment for covariates and allowance for overdispersion. Method: Analysis of simulated and real survival data. Results: It describes how centred hazard ratio estimates adjusted for covariates can be obtained from a Cox regression and gives details of the necessary programming in Stata. Allowance for overdispersion can be made by multiplying the standard errors by a factor based on either the model or the log-rank χ2 statistics. Simulated results and a real example are presented. Conclusion: Funnel plots based on hazard ratios are easier to interpret than multiple Kaplan–Meier survival plots, and in contrast to funnel plots based on survival at, say, 5 years, are less open to accusations of bias and use more information. The interpretation of such plots may be enhanced by using standard meta-analysis methods. Hazard ratio comparisons may now be added to the repertoire of techniques used by Cancer Registries, Primary Care Trusts, and other commissioners of healthcare. ER -