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If a new treatment appears to improve median overall survival in a group of patients, is there any way to determine whether this improvement results from 'all' those treated surviving a few months longer, or whether it results from only a few individuals benefiting for a much longer time than the median (i.e. basically being 'cured'), while the majority receive no benefit from the treatment? Presumably both scenarios could give a similar apparent survival improvement.
ichbin
10-20-2010, 12:23 AM
Well, you could construct parameterized models for both scenarios and see which model fit the data better. But I would start by just plotting the survival times of treatment and control groups. Presumably in the few-are-cured scenario, you would see a group of outliers in the treatment group that weren't there in the control group.
Well, you could construct parameterized models for both scenarios and see which model fit the data better. But I would start by just plotting the survival times of treatment and control groups. Presumably in the few-are-cured scenario, you would see a group of outliers in the treatment group that weren't there in the control group.
How does one construct such parameterized models - I presume I need help from a statistician, or can this be attempted using a statistics package? Apologies for my complete ignorance!
I agree with ICHBIN that you should plot the survival curves and just comment on them, since this is likely to be better understood by audience.
I think that the statement
"improvement results from 'all' those treated surviving a few months longer"
corresponds to a null hypothesis that the Survival curve of the treated and the Survival curve of the untreated are simple location shifts of one and other?
I guess the alternative is they are not simple location shifts.
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