Open AccessPotential Bias Associated with Modeling the Effectiveness of Healthcare Interventions in Reducing Mortality Using an Overall Hazard Ratio
Author(s) -
Fernando AlaridEscudero,
Karen M. Kuntz
Publication year - 2019
Publication title -
pharmacoeconomics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.809
H-Index - 100
eISSN - 1179-2027
pISSN - 1170-7690
DOI - 10.1007/s40273-019-00859-5
Subject(s) - medicine , life expectancy , hazard ratio , cohort , mortality rate , psychological intervention , cohort study , disease , quality adjusted life year , demography , cost effectiveness , confidence interval , environmental health , population , risk analysis (engineering) , psychiatry , sociology
Clinical trials often report intervention efficacy in terms of the reduction in all-cause mortality between the treatment and control arms (i.e., an overall hazard ratio [oHR]) instead of the reduction in disease-specific mortality (i.e., a disease-specific hazard ratio [dsHR]). Using oHR to reduce all-cause mortality beyond the time horizon of the trial may introduce bias if the relative proportion of other-cause mortality increases with age. We sought to quantify this oHR extrapolation bias and propose a new approach to overcome this bias.