The importance of identifying and validating prognostic factors in oncology.
The importance of identifying and validating prognostic factors in oncology.
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DOI：
10.1053/j.seminoncol.2010.04.001
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发表时间：
2010-04
影响因子：
4
通讯作者：
Owzar K
中科院分区：
文献类型：
--
作者：
Halabi S;Owzar K
预后在患者管理和决策中起着至关重要的作用。预后因素的评估将基线临床和实验协变量与结果联系起来，是临床研究的主要目标之一。从历史上看，识别预后因素的动力是需要准确估计调整这些变量的治疗效果。在肿瘤学中，结果的变异性可能与预后因素有关，而不是与治疗的差异有关。在本文中，我们首先简要回顾预后因素，然后对其重要性进行一般性讨论。接下来，我们在提出用于识别这些因素的各种建模方法之前描述研究设计的重要性并讨论不同方法的相对值。我们在已发表和正在进行的肿瘤学 III 期试验的框架内阐述了这些概念。
Prognosis plays a vital role in patient management and decision making. The assessment of prognostic factors, which relate baseline clinical and experimental covariables to outcomes, is one of the major objectives in clinical research. Historically, the impetus for the identification of prognostic factors has been the need to accurately estimate the effect of treatment adjusting for these variables. In oncology, the variability in outcome may be related to prognostic factors rather than to differences in treatments. In this article, we begin with a brief review of prognostic factors, and then subsequently offer a general discussion of their importance. Next, we describe the significance of study design before presenting various modeling approaches for identifying these factors and discussing the relative values of the different approaches. We illustrate the concepts within the framework of published and ongoing phase III trials in oncology.