Should clinically meaningful outcomes in cancer be based on individual survival rather than median overall survival?. (September 2017)

• Record Type: Journal Article
• Authors: Sacristán, José A; Dilla, Tatiana; Garrido, Pilar; Avendaño, Cristina; Cruz-Hernández, Juan J; Espinosa, Javier; Comellas, Marta; Lizán, Luis
• Is Part Of: Journal of comparative effectiveness research. Volume 6:Number 6(2017)
• Page Start: 491
• Page End: 495
• Publication Date: 2017-09
• Subjects: cost -- cost–effectiveness -- efficiency -- health outcomes -- oncology -- patients -- treatment; Medical care -- Research -- Periodicals; Medical care -- Research -- Evaluation -- Periodicals; Medical care -- Decision making -- Periodicals; Evidence-based medicine -- Periodicals; Medicine, Comparative -- Periodicals; 362.1072
• DOI: 10.2217/cer-2016-0081
• Languages: English
• ISSNs: 2042-6305

Abstract

Aim: To assess whether the use of median overall survival to define clinically meaningful outcomes in the area of oncology could yield different decisions compared with those obtained with a more realistic measure such as individual survival.Methods: Two scenarios that offered equivalent health gains/money spent were presented: 'median overall survival' scenario (new treatment provided small clinical benefits for the average population) and 'individual survival'scenario (new treatment provided substantial clinical benefits for a small percentage of the patients and no benefits for the rest). Responses from both scenarios were compared.Results: Responses between the two scenarios were different for oncologists, healthcare policy makers and patients (p < 0.05). 'Individual survival' scenario obtained higher percentage of positive answers compared with 'median overall survival'.Conclusion: Expressing the benefits of new oncologic treatments in terms of 'individual survival' may yield to different healthcare decisions compared with the widely used median overall survival.