Biomedical subjects
Publications and source records attributed to Lesley Stewart.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We report an updated systematic review and individual patient data meta-analysis of the effectiveness of postoperative radiotherapy (PORT) in non-small-cell lung cancer. Results continue to show PORT to be detrimental, with an 18% relative increase in the risk of death. Similar detriments were observed for local recurrence-free survival, distant recurrence-free survival and overall recurrence-free survival. There continues to be evidence that the effects of PORT are more harmful in those patients with stage I disease than those with stage II disease.
BACKGROUND: The hazard ratio (HR) is the most appropriate measure for time to event outcomes such as survival. In systematic reviews, HRs can be calculated either from the raw trial data obtained as part of an individual patient data (IPD) meta-analysis or from the appropriate trial-level summary statistics. However, the information required for the latter are seldom reported in sufficient detail to allow reviewers to calculate HRs. In contrast, the median survival and survival rates at specific time points are frequently presented. We aimed to evaluate retrospectively the performance of meta-analyses using median survival times and survival rates by comparing them with meta-analyses using IPD to calculate HRs. METHODS: IPD from thirteen published meta-analyses (MAs) in cancers with high mortality rates were used. Median survival and survival rates were calculated from the IPD rather than taken from publications so that the same trials, patients, and extended follow-up are used in each analysis. RESULTS AND CONCLUSIONS: We show that using median survival times or survival rates at a particular point in time are not reasonable surrogate measures for meta-analyses of survival outcomes and that, wherever possible, HRs should be calculated. Individual trial publications reporting on time to event outcomes, therefore, should provide more detailed statistical information, preferably logHRs and their variances, or their estimators.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.