Data-Adaptive and Model-Robust Covariate Adjustment for Time-to-Event Outcomes in Stratified Randomized Trials

Fuente: arXiv
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Auteurs principaux: Kim, Raphael C., Gilbert, Brian, Zabih, Ramin, Santacatterina, Michele, Diaz, Ivan
Format: Preprint
Publié: 2026
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author Kim, Raphael C.
Gilbert, Brian
Zabih, Ramin
Santacatterina, Michele
Diaz, Ivan
author_facet Kim, Raphael C.
Gilbert, Brian
Zabih, Ramin
Santacatterina, Michele
Diaz, Ivan
contents Time-to-event outcomes are commonly used as primary endpoints in randomized clinical trials. Despite this, relatively little work incorporates baseline covariate information while also accounting for stratified randomization, a common form of randomization. Moreover, leveraging efficiency gains using these approaches typically requires pre-specifying a subset of covariates that are most predictive of the outcome -- a challenging task in practice, as most trials collect dozens of potentially prognostic baseline variables. In this work, we build on existing literature to propose a data-adaptive and model-robust covariate adjustment method for time-to-event outcomes. Our approach, based on targeted minimum loss-based estimation, allows for data-adaptive covariate selection and model-robust efficient inference on functionals of the survival curve while accounting for stratification. Through extensive simulations and analysis, we showcase the simplicity and improved precision of our method when the covariate set is not known a priori.
format Preprint
id arxiv_https___arxiv_org_abs_2604_28047
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Data-Adaptive and Model-Robust Covariate Adjustment for Time-to-Event Outcomes in Stratified Randomized Trials
Kim, Raphael C.
Gilbert, Brian
Zabih, Ramin
Santacatterina, Michele
Diaz, Ivan
Methodology
Time-to-event outcomes are commonly used as primary endpoints in randomized clinical trials. Despite this, relatively little work incorporates baseline covariate information while also accounting for stratified randomization, a common form of randomization. Moreover, leveraging efficiency gains using these approaches typically requires pre-specifying a subset of covariates that are most predictive of the outcome -- a challenging task in practice, as most trials collect dozens of potentially prognostic baseline variables. In this work, we build on existing literature to propose a data-adaptive and model-robust covariate adjustment method for time-to-event outcomes. Our approach, based on targeted minimum loss-based estimation, allows for data-adaptive covariate selection and model-robust efficient inference on functionals of the survival curve while accounting for stratification. Through extensive simulations and analysis, we showcase the simplicity and improved precision of our method when the covariate set is not known a priori.
title Data-Adaptive and Model-Robust Covariate Adjustment for Time-to-Event Outcomes in Stratified Randomized Trials
topic Methodology
url https://arxiv.org/abs/2604.28047