A formal test for the stationarity of the incidence rate using data from a prevalent cohort study with follow-up

In a prevalent cohort study with follow-up, the incidence process is not directly observed since only the onset times of prevalent cases can be ascertained. Assessing the “stationarity” of the underlying incidence process can be important for at least three reasons, including an improvement in efficiency when estimating the survivor function. We propose, for the first time, a formal test for stationarity using data from a prevalent cohort study with follow-up. The test makes use of a characterization of stationarity, an extension of this characterization developed in this paper, and of a test for matched pairs of right censored data. We report the results from a power study assuming varying degrees of departure from the null hypothesis of stationarity. The test is also applied to data obtained as part of the Canadian Study of Health and Aging (CSHA) to verify whether the incidence rate of dementia amongst the elderly in Canada has remained constant.