Should clinically meaningful outcomes in cancer be based on individual survival rather than median overall survival?

J Comp Eff Res. 2017 Sep;6(6):491-495. doi: 10.2217/cer-2016-0081. Epub 2017 Sep 29.

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.

Keywords: cost; cost–effectiveness; efficiency; health outcomes; oncology; patients; treatment.

MeSH terms

  • Attitude of Health Personnel
  • Clinical Decision-Making
  • Cost-Benefit Analysis
  • Health Policy / economics
  • Humans
  • Medical Oncology / economics
  • Medical Oncology / statistics & numerical data
  • Neoplasms / economics
  • Neoplasms / mortality*
  • Neoplasms / therapy
  • Oncologists / psychology
  • Patient Satisfaction
  • Survival Analysis
  • Treatment Outcome