The importance of identifying and validating prognostic factors in oncology - PubMed (original) (raw)

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The importance of identifying and validating prognostic factors in oncology

Susan Halabi et al. Semin Oncol. 2010 Apr.

Abstract

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.

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Figures

Figure 1

Relationship between host, tumor, environmental and clinical outcomes.

Figure 2

Regression tree for progression-free survival in men with CRPC.

Figure 3

An illustration of noise discovery due to overfitting using the logistic regression model.

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The importance of identifying and validating prognostic factors in oncology - PubMed (original) (raw)