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Quantifying bias in survival estimates resulting from loss to follow‐up among children with lymphoma in Malawi
Author(s) -
Stanley Christopher C.,
Westmoreland Kate D.,
Itimu Salama,
Salima Ande,
der Gronde Toon,
Wasswa Peter,
Mtete Idah,
Butia Mercy,
ElMallawany Nader K.,
Gopal Satish
Publication year - 2017
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26370
Subject(s) - medicine , interquartile range , confidence interval , prospective cohort study , overall survival , lymphoma , pediatrics
Pediatric lymphoma is common in sub‐Saharan Africa, where survival estimates are often based on limited follow‐up with incomplete retention, introducing potential for bias. We compared follow‐up and overall survival (OS) between passive and active tracing within a prospective cohort of children with lymphoma in Malawi. Median follow‐up times were 4.4 months (interquartile range [IQR] 2.0–9.4) and 10.8 months (IQR 6.2–20.6) in passive and active follow‐up, respectively. Twelve‐month overall survival (OS) was 69% (95% confidence interval [CI] 54–80) in passive and 44% (95% CI 34–54) in active follow‐up. Passive follow‐up significantly overestimated the OS and underestimated the mortality. Efforts to improve retention in regional studies are needed.