ArticleCancer2008
Limits of observational data in determining outcomes from cancer therapy.
Article in Cancer, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
89 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prostate radiotherapy and the risk of secondary rectal cancer-a meta-analysis.International journal of colorectal disease · 2022Pooled it
- Association of Black Race With Prostate Cancer-Specific and Other-Cause Mortality.JAMA oncology · 2019Trial
- Two-Decade Trends in Radiotherapy Patterns and Clinical Outcomes for Soft Tissue Sarcoma: A Nationwide Study in South Korea (2005-2023).Cancer medicine · 2026Article
- Long-term oncological outcomes from a prospective cohort of patients with localised prostate cancer.BJU international · 2026Article
- Dysphagia and Functional Limitations Among Adults in the United States: Findings from the 2022 National Health Interview Survey.Dysphagia · 2024Article
- Time-varying associations of patient and tumor characteristics with cancer survival: an analysis of SEER data across 14 cancer sites, 2004-2017.Cancer causes & control : CCC · 2024Article
- Trends in kidney transplantation and living donor nephrectomy in Germany: a total population analysis from 2006 to 2021.World journal of urology · 2024Article
- Real-World Effectiveness of Palbociclib Plus Aromatase Inhibitors in African American Patients With Metastatic Breast Cancer.The oncologist · 2023Article
- Adjuvant Therapy for Elderly Breast Cancer Patients after Breast-Conserving Surgery: Outcomes in Real World Practice.Cancers · 2023Article
- The Increasing Importance of Rigorous Real-World Evidence.JNCI cancer spectrum · 2022Article
- Outcomes following radical prostatectomy or external beam radiation for veterans with Gleason 9 and 10 prostate cancer.Cancer medicine · 2022Article
- Oligometastatic Prostate Cancer: A Comparison between Multimodality Treatment vs. Androgen Deprivation Therapy Alone.Cancers · 2022Article
- Uncovering interpretable potential confounders in electronic medical records.Nature communications · 2022Article
- Article
- Real-World Evidence of Traditional Chinese Medicine (TCM) Treatment on Cancer: A Literature-Based Review.Evidence-based complementary and alternative medicine : eCAM · 2022Review
- Partial versus total adrenalectomy for pheochromocytoma: a population-based comparison of outcomes.International urology and nephrology · 2021Article
- Crosstalk between Statins and Cancer Prevention and Therapy: An Update.Pharmaceuticals (Basel, Switzerland) · 2021Review
- Effects of Adjuvant Endocrine Therapy Adherence and Radiation on Recurrence and Survival Among Older Women with Early-Stage Breast Cancer.Annals of surgical oncology · 2021Article
- Prostate cancer in multi-ethnic Asian men: Real-world experience in the Malaysia Prostate Cancer (M-CaP) Study.Cancer medicine · 2021Article
- Adoption of New Risk Stratification Technologies Within US Hospital Referral Regions and Association With Prostate Cancer Management.JAMA network open · 2021Article
29 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundObservational data are used increasingly to assess the effectiveness of therapies. However, selection biases are likely to have an impact on results and threaten the validity of these studies.
methodsThe primary objective of the current study was to explore the effect of selection biases in observational studies of treatment effectiveness in cancer care. Patients were identified from the Surveillance, Epidemiology, and End Results-Medicare linked database. The following groups of patients were included: 5245 men treated with and without androgen deprivation for locally advanced prostate cancer, 43,847 men with active treatment versus observation for low- and intermediate-risk prostate cancer, and 4860 patients with lymph node-positive colon cancer who were treated with and without fluorouracil chemotherapy. Patients were compared by therapy for the outcomes of cancer-specific mortality, other-cause mortality, and overall mortality.
resultsIn all comparisons, the observational data produced improbable results. For example, when evaluating outcomes of men who were treated with and without androgen deprivation for locally advanced prostate cancer, men who underwent androgen deprivation had higher prostate cancer mortality (hazard ratio, 1.5; 95% confidence interval, 1.29-1.92) despite clinical trial evidence that this treatment improves cancer mortality. Controlling for comorbidity, extent of disease, and other characteristics by multivariate analyses or by propensity analyses had remarkably small impact on these improbable results.
conclusionsThe current results suggested that the results from observational studies of treatment outcomes should be viewed with caution.
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