Risk-difference curves can be used to communicate time-dependent effects of adjuvant therapies for early stage cancer

被引:9
作者
Coory, Michael [1 ,2 ]
Lamb, Karen E. [1 ,2 ]
Sorich, Michael [3 ]
机构
[1] Royal Childrens Hosp, Murdoch Childrens Res Inst, Clin Epidemiol & Biostat Unit, Melbourne, Vic 3052, Australia
[2] Royal Childrens Hosp, Dept Pediat, Melbourne, Vic 3052, Australia
[3] Flinders Univ S Australia, Sch Med, Dept Clin Pharmacol, Bedford Pk, SA 5042, Australia
基金
英国医学研究理事会;
关键词
Survival; Hazard ratio; Risk-difference curve; Kaplan-Meier curves; Time-dependent treatment effect; Difference-in-mean survival; Difference-in-median survival; Relative treatment effect; Absolute treatment effect; SURVIVAL CURVES; CLINICAL-TRIALS; EFFICACY; HAZARDS; PATIENT; VACCINE; TREAT;
D O I
10.1016/j.jclinepi.2014.03.006
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objectives: To describe the use of risk-difference curves for communicating time-dependent absolute treatment effects. Study Design and Setting: Three examples based on individual patient data meta-analyses for adjuvant treatments for early-stage breast cancer are presented. Unit record datasets were re-created from the published Kaplan-Meier curves and numbers at risk or person-years at risk. Risk-difference curves, with corresponding 95% confidence bands, are presented and discussed. Results: Risk-difference curves are useful for communicating the results from trials of adjuvant treatments for early-stage cancer when standard measures of the absolute treatment effect for survival data (ie, difference-in-mean and difference-in-median survival) can be difficult to estimate. They also avoid the problem of "evolving selection bias", which can affect interval-specific hazard ratio (HR)s in trials with long follow-up and where the participants are heterogeneous with respect to prognosis. Conclusion: Clinical epidemiologists should consider reporting risk-difference curves in addition to Kaplan-Meier curves and the HR. Crown Copyright (C) 2014 Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:966 / 972
页数:7
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