Previous studies have discouraged the use of the Cox proportional hazards (PH) model for traditional mediation analysis as it might provide biased results. Accelerated failure time (AFT) models have been proposed as an alternative for Cox PH models. In addition, the use of the potential outcomes framework has been proposed for mediation models with time-to-event outcomes. The aim of this paper is to investigate the performance of traditional mediation analysis and potential outcomes mediation analysis based on both the Cox PH and the AFT model. This is done by means of a Monte Carlo simulation study and the illustration of the methods using an empirical data set. Both the product-of-coefficients method of the traditional mediation analysis and the potential outcomes framework yield unbiased estimates with respect to their own underlying indirect effect value for simple mediation models with a time-to-event outcome and estimated based on Cox PH or AFT.

中文翻译：

---

使用事件发生时间结果进行中介分析的方法的性能

以前的研究不鼓励将 Cox 比例风险 (PH) 模型用于传统的中介分析，因为它可能会提供有偏差的结果。已提出加速失效时间 (AFT) 模型作为 Cox PH 模型的替代方案。此外，还建议将潜在结果框架用于具有时间到事件结果的中介模型。本文的目的是研究基于 Cox PH 和 AFT 模型的传统中介分析和潜在结果中介分析的性能。这是通过蒙特卡罗模拟研究和使用经验数据集的方法说明来完成的。