Prognostic markers in cancer: the evolution of evidence from single studies to meta-analysis, and beyond.

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 pr...

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Main Authors: Riley, R, Sauerbrei, W, Altman, D
Format: Journal article
Language:English
Published: 2009
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author Riley, R
Sauerbrei, W
Altman, D
author_facet Riley, R
Sauerbrei, W
Altman, D
author_sort Riley, R
collection OXFORD
description 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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spelling oxford-uuid:8575d56c-58e8-40b2-af98-4d6e8bd220892022-03-26T21:57:48ZPrognostic markers in cancer: the evolution of evidence from single studies to meta-analysis, and beyond.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8575d56c-58e8-40b2-af98-4d6e8bd22089EnglishSymplectic Elements at Oxford2009Riley, RSauerbrei, WAltman, DIn 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.
spellingShingle Riley, R
Sauerbrei, W
Altman, D
Prognostic markers in cancer: the evolution of evidence from single studies to meta-analysis, and beyond.
title Prognostic markers in cancer: the evolution of evidence from single studies to meta-analysis, and beyond.
title_full Prognostic markers in cancer: the evolution of evidence from single studies to meta-analysis, and beyond.
title_fullStr Prognostic markers in cancer: the evolution of evidence from single studies to meta-analysis, and beyond.
title_full_unstemmed Prognostic markers in cancer: the evolution of evidence from single studies to meta-analysis, and beyond.
title_short Prognostic markers in cancer: the evolution of evidence from single studies to meta-analysis, and beyond.
title_sort prognostic markers in cancer the evolution of evidence from single studies to meta analysis and beyond
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AT altmand prognosticmarkersincancertheevolutionofevidencefromsinglestudiestometaanalysisandbeyond