Estimating lead-time bias in lung cancer diagnosis of patients with previous cancers.
Estimating lead-time bias in lung cancer diagnosis of patients with previous cancers.
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DOI：
10.1002/sim.7691
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发表时间：
2018-07-20
影响因子：
2
通讯作者：
Pruitt SL
中科院分区：
文献类型：
--
作者：
Ge Z;Heitjan DF;Gerber DE;Xuan L;Pruitt SL
令人惊讶的是，人们发现，那些曾经患过癌症的人比那些以前没有患过癌症的人诊断出肺癌后的生存期更长。一个可能的解释是提前期偏差，通过提前诊断时间，显然可以延长患有既往癌症的患者的生存期，即使他们没有真正的临床优势。我们提出了一个离散参数模型来共同描述无既往癌症组（根据定义，不存在提前期偏差）和既往癌症组（可能存在提前期偏差）的生存率。我们使用负二项式分布对交付时间进行建模，并使用 Logit 风险量表上的线性样条对交付后生存进行建模，这使得即使在没有偏差的情况下，两组之间的生存也存在差异；我们将模型表示为 LS/NB（Logit-Spline/Negative Binomial）。我们将 LS/NB 拟合到监测、流行病学和最终结果 (SEER)-医疗保险相关数据集的倾向评分匹配子集，进行敏感性分析以评估关键假设的影响。以肺癌特异性死亡为终点，I 期和 II 期患者的平均提前期估计约为 11 个月；就总生存而言，I期和II期大约为3.4个月。对于晚期肺癌患者，两种结果的平均提前时间均为 1 个月或更短。考虑到前置时间偏差会降低先前癌症组（如果存在）的生存优势，但并不能在所有情况下都消除这种优势。
Surprisingly, survival from a diagnosis of lung cancer has been found to be longer for those who experienced a previous cancer than for those with no previous cancer. A possible explanation is lead-time bias, which, by advancing the time of diagnosis, apparently extends survival among those with a previous cancer even when they enjoy no real clinical advantage. We propose a discrete parametric model to jointly describe survival in a no-previous-cancer group (where, by definition, lead-time bias cannot exist) and in a previous-cancer group (where lead-time bias is possible). We model the lead time with a negative binomial distribution and the post-lead-time survival with a linear spline on the logit hazard scale, which allows for survival to differ between the two groups even in the absence of bias; we denote our model LS/NB (Logit-Spline/Negative Binomial). We fit LS/NB to a propensity-score matched subset of the Surveillance, Epidemiology & End Results (SEER)-Medicare linked data set, conducting sensitivity analyses to assess the effects of key assumptions. With lung-cancer-specific death as the endpoint, the estimated mean lead time is roughly 11 months for stage I&II patients; with overall survival, it is roughly 3.4 months in stage I&II. For patients with higher-stage lung cancers, the mean lead time is 1 month or less for both outcomes. Accounting for lead-time bias reduces the survival advantage of the previous-cancer group when one exists, but it does not nullify it in all cases.
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影响因子：
5.3
作者：
Laccetti, Andrew L.;Pruitt, Sandi L.;Gerber, David E.
通讯作者：
Gerber, David E.
影响因子：
2
作者：
WALTER, SD;STITT, LW
通讯作者：
STITT, LW
影响因子：
3.7
作者：
EFRON, B
通讯作者：
EFRON, B
DOI：
10.1093/jnci/95.12.868
发表时间：
2003-06-18
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
Draisma, G;Boer, R;de Koning, HJ
通讯作者：
de Koning, HJ
影响因子：
1.9
作者：
DAY, NE;WALTER, SD
通讯作者：
WALTER, SD