Estimation of win, loss probabilities, and win ratio based on right-censored event data

The win ratio has in the recent decade gained popularity for analyzing prioritized multiple event data in clinical cohort studies, in particular within cardiovascular research. The literature on estimation of the win ratio using censored event data is however sparse. The methods that have been suggested have either an insufficient adjustment of the censoring or by assuming the the win and loss probabilities are proportional over time. The assumption of proportional win and loss probabilities will often in practice not be satisfied. In this paper, we present estimates for the win ratio, and win and loss probabilities, under independent right-censoring and derive the asymptotic distribution of the estimates. The proposed win ratio estimate does not require the assumption of proportional win and loss probabilities. The small sample properties of the proposed method are studied in a simulation study showing that the variance formula is accurate even for small samples. The method is applied on two data sets.