A new graphic for quality adjusted life years (Q-TWiST) survival analysis: The Q-TWiST plot

Jeff A. Sloan; Daniel J. Sargent; Jed Lindman; Cristine Allmer; Delfino Vargas-Chanes; Edward T. Creagan; James A. Bonner; Michael J. O'Connell; Robert J. Dalton; Kendrith M. Rowland; Burke J. Brooks; John A. Laurie

doi:10.1023/A:1014401516011

A new graphic for quality adjusted life years (Q-TWiST) survival analysis: The Q-TWiST plot

Jeff A. Sloan, Daniel J. Sargent, Jed Lindman, Cristine Allmer, Delfino Vargas-Chanes, Edward T. Creagan, James A. Bonner, Michael J. O'Connell, Robert J. Dalton, Kendrith M. Rowland, Burke J. Brooks, John A. Laurie

Research output: Contribution to journal › Article › peer-review

Abstract

One of the challenges of interpreting a Quality-adjusted time without symptoms of disease and toxicity (Q-TWiST) analysis is examining the sensitivity of conclusions that may be drawn to varying values of the utility coefficients for days with toxicity and days after disease progression. We present a graphic that parsimoniously displays the impact on median Q-TWiST survival across treatment groups of varying values of the utility coefficients. The goal of the graphic is to present a concise Q-TWiST analysis. We use Zhao and Tsiatis (Biometrika 1997; 84(2): 339-348) to adjust for the bias in Kaplan-Meier (K-M) estimates. The graphic contains bounds that approximate points for which statistical significance would be achieved by comparing the median Q-TWiST survival between treatment alternatives for each value of the utility coefficients. The plot may be generalized to compare Q-TWiST means, medians or percentiles across treatment groups. We demonstrate the application of the Q-TWiST plot through a re-analysis of a randomized phase III North Central Cancer Treatment Group (NCCTG) clinical trial of recombinant Interferon-2α in patients with malignant melanoma. We explore alternative options to customize the graphic representation for other data sets drawn from several NCCTG clinical trials.

Original language	English (US)
Pages (from-to)	37-45
Number of pages	9
Journal	Quality of Life Research
Volume	11
Issue number	1
DOIs	https://doi.org/10.1023/A:1014401516011
State	Published - 2002
Externally published	Yes

Keywords

Kaplan-Meier estimates
Q-TWiST
Survival analysis

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health

Online availability

10.1023/A:1014401516011

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@article{de7a2d093ff6409fb9e77763bb8ac218,

title = "A new graphic for quality adjusted life years (Q-TWiST) survival analysis: The Q-TWiST plot",

abstract = "One of the challenges of interpreting a Quality-adjusted time without symptoms of disease and toxicity (Q-TWiST) analysis is examining the sensitivity of conclusions that may be drawn to varying values of the utility coefficients for days with toxicity and days after disease progression. We present a graphic that parsimoniously displays the impact on median Q-TWiST survival across treatment groups of varying values of the utility coefficients. The goal of the graphic is to present a concise Q-TWiST analysis. We use Zhao and Tsiatis (Biometrika 1997; 84(2): 339-348) to adjust for the bias in Kaplan-Meier (K-M) estimates. The graphic contains bounds that approximate points for which statistical significance would be achieved by comparing the median Q-TWiST survival between treatment alternatives for each value of the utility coefficients. The plot may be generalized to compare Q-TWiST means, medians or percentiles across treatment groups. We demonstrate the application of the Q-TWiST plot through a re-analysis of a randomized phase III North Central Cancer Treatment Group (NCCTG) clinical trial of recombinant Interferon-2α in patients with malignant melanoma. We explore alternative options to customize the graphic representation for other data sets drawn from several NCCTG clinical trials.",

keywords = "Kaplan-Meier estimates, Q-TWiST, Survival analysis",

author = "Sloan, {Jeff A.} and Sargent, {Daniel J.} and Jed Lindman and Cristine Allmer and Delfino Vargas-Chanes and Creagan, {Edward T.} and Bonner, {James A.} and O'Connell, {Michael J.} and Dalton, {Robert J.} and Rowland, {Kendrith M.} and Brooks, {Burke J.} and Laurie, {John A.}",

note = "Funding Information: This study was conducted as a collaborative trial of the North Central Cancer Treatment Group and Mayo Clinic and was supported in part by Public Health Service grants CA-15083, CA-25224, CA-37-404, CA-35195, CA-52352, CA-35101, CA-35269, CA-37417, CA-35448, CA-63849, CA-35272, CA-35113, and CA-35415 from the National Cancer Institute Department of Health and Human Services.",

year = "2002",

doi = "10.1023/A:1014401516011",

language = "English (US)",

volume = "11",

pages = "37--45",

journal = "Quality of Life Research",

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T1 - A new graphic for quality adjusted life years (Q-TWiST) survival analysis

T2 - The Q-TWiST plot

AU - Sloan, Jeff A.

AU - Sargent, Daniel J.

AU - Lindman, Jed

AU - Allmer, Cristine

AU - Vargas-Chanes, Delfino

AU - Creagan, Edward T.

AU - Bonner, James A.

AU - O'Connell, Michael J.

AU - Dalton, Robert J.

AU - Rowland, Kendrith M.

AU - Brooks, Burke J.

AU - Laurie, John A.

N1 - Funding Information: This study was conducted as a collaborative trial of the North Central Cancer Treatment Group and Mayo Clinic and was supported in part by Public Health Service grants CA-15083, CA-25224, CA-37-404, CA-35195, CA-52352, CA-35101, CA-35269, CA-37417, CA-35448, CA-63849, CA-35272, CA-35113, and CA-35415 from the National Cancer Institute Department of Health and Human Services.

PY - 2002

Y1 - 2002

N2 - One of the challenges of interpreting a Quality-adjusted time without symptoms of disease and toxicity (Q-TWiST) analysis is examining the sensitivity of conclusions that may be drawn to varying values of the utility coefficients for days with toxicity and days after disease progression. We present a graphic that parsimoniously displays the impact on median Q-TWiST survival across treatment groups of varying values of the utility coefficients. The goal of the graphic is to present a concise Q-TWiST analysis. We use Zhao and Tsiatis (Biometrika 1997; 84(2): 339-348) to adjust for the bias in Kaplan-Meier (K-M) estimates. The graphic contains bounds that approximate points for which statistical significance would be achieved by comparing the median Q-TWiST survival between treatment alternatives for each value of the utility coefficients. The plot may be generalized to compare Q-TWiST means, medians or percentiles across treatment groups. We demonstrate the application of the Q-TWiST plot through a re-analysis of a randomized phase III North Central Cancer Treatment Group (NCCTG) clinical trial of recombinant Interferon-2α in patients with malignant melanoma. We explore alternative options to customize the graphic representation for other data sets drawn from several NCCTG clinical trials.

AB - One of the challenges of interpreting a Quality-adjusted time without symptoms of disease and toxicity (Q-TWiST) analysis is examining the sensitivity of conclusions that may be drawn to varying values of the utility coefficients for days with toxicity and days after disease progression. We present a graphic that parsimoniously displays the impact on median Q-TWiST survival across treatment groups of varying values of the utility coefficients. The goal of the graphic is to present a concise Q-TWiST analysis. We use Zhao and Tsiatis (Biometrika 1997; 84(2): 339-348) to adjust for the bias in Kaplan-Meier (K-M) estimates. The graphic contains bounds that approximate points for which statistical significance would be achieved by comparing the median Q-TWiST survival between treatment alternatives for each value of the utility coefficients. The plot may be generalized to compare Q-TWiST means, medians or percentiles across treatment groups. We demonstrate the application of the Q-TWiST plot through a re-analysis of a randomized phase III North Central Cancer Treatment Group (NCCTG) clinical trial of recombinant Interferon-2α in patients with malignant melanoma. We explore alternative options to customize the graphic representation for other data sets drawn from several NCCTG clinical trials.

KW - Kaplan-Meier estimates

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KW - Survival analysis

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SN - 0962-9343

VL - 11

SP - 37

EP - 45

JO - Quality of Life Research

JF - Quality of Life Research

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ER -

A new graphic for quality adjusted life years (Q-TWiST) survival analysis: The Q-TWiST plot

Abstract

Keywords

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