Prognostic markers in cancer: the evolution of evidence from single studies to meta-analysis, and beyond.
Prognostic markers in cancer: the evolution of evidence from single studies to meta-analysis, and beyond.
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DOI：
10.1038/sj.bjc.6604999
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发表时间：
2009-04-21
影响因子：
8.8
通讯作者：
Altman DG
中科院分区：
文献类型：
--
作者：
Riley RD;Sauerbrei W;Altman DG
在肿瘤学中，预后指标是用于帮助推断个体患者未来结果风险的临床指标，如原发性治疗后疾病复发。因此，他们促进了个人治疗选择和帮助患者咨询。因此，关于预后标记的循证结果对临床医生和患者都非常重要。然而，越来越多的人意识到，在提高医学研究的过程中，预后标志物的研究被忽视了。大型协议驱动的前瞻性研究是理想的，适当的统计分析和对所使用的方法和获得的结果进行清晰、公正的报告。不幸的是，已发表的预后研究很少达到这样的标准，系统评价和荟萃分析往往只能引起人们对缺乏高质量证据的关注。我们讨论了高质量的预后标志物证据如何随着时间的推移从最初的探索性研究，到大型协议驱动的初级研究，然后到荟萃分析甚至更远，到大型前瞻性计划汇总分析和肿瘤库的启动。我们重点介绍了促进这一过程每个阶段的文章，并促进了旨在改进预后标志物研究的设计、分析和报告的现行指南。我们还概述了为什么合作，多中心和多学科团队应该是未来研究的重要组成部分。
In oncology, prognostic markers are clinical measures used to help elicit an individual patient's risk of a future outcome, such as recurrence of disease after primary treatment. They thus facilitate individual treatment choice and aid in patient counselling. Evidence-based results regarding prognostic markers are therefore very important to both clinicians and their patients. However, there is increasing awareness that prognostic marker studies have been neglected in the drive to improve medical research. Large protocol-driven, prospective studies are the ideal, with appropriate statistical analysis and clear, unbiased reporting of the methods used and the results obtained. Unfortunately, published prognostic studies rarely meet such standards, and systematic reviews and meta-analyses are often only able to draw attention to the paucity of good-quality evidence. We discuss how better-quality prognostic marker evidence can evolve over time from initial exploratory studies, to large protocol-driven primary studies, and then to meta-analysis or even beyond, to large prospectively planned pooled analyses and to the initiation of tumour banks. We highlight articles that facilitate each stage of this process, and that promote current guidelines aimed at improving the design, analysis, and reporting of prognostic marker research. We also outline why collaborative, multi-centre, and multi-disciplinary teams should be an essential part of future studies.
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影响因子：
7.2
作者：
Hayden, J. A.;Cote, P.;Bombardier, C.
通讯作者：
Bombardier, C.
影响因子：
11.5
作者：
Filipits, Martin;Haddad, Vincent;Pirker, Robert
通讯作者：
Pirker, Robert
影响因子：
7.7
作者：
Blettner, M;Sauerbrei, W;Friedenreich, C
通讯作者：
Friedenreich, C
影响因子：
2.3
作者：
Boffetta, P;Soutar, A;Weiderpass, E
通讯作者：
Weiderpass, E
在癌症期刊上发表的生存分析的综述。
影响因子：
8.8
作者：
Altman, D G;De Stavola, B L;Love, S B;Stepniewska, K A
通讯作者：
Stepniewska, K A