In analyses of patient survival it is often desirable to compare obser
ved survival curves with expected survival curves based on information
obtained from the general population. However, current methods of cal
culating expected survival curves are difficult to interpret and are o
ften poorly documented, We discuss an alternative formulation of the s
o-called direct method which we recommend for general use. By simulati
on, we show that the expected survival curve obtained from this method
represents the expectation of a Kaplan-Meier curve for a set of rando
m population controls. Thus, the term expected survival does not refer
to the expectation of patient survival, but rather to the expected su
rvival curve for a random set of controls. The alternative methods are
discussed, and we illustrate the methods in an analysis of long time
survival of a population-based sample of peptic ulcer patients. (C) 19
98 John Wiley & Sons, Ltd.