Evidence map›Paper›PMID 25335959›Full record

ArticleBMJ open2014

Benchmarks for detecting 'breakthroughs' in clinical trials: empirical assessment of the probability of large treatment effects using kernel density estimation.

Branko Miladinovic, Ambuj Kumar, Rahul Mhaskar, Benjamin Djulbegovic

Abstract read
In one paragraph

Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Branko MiladinovicDivision and Center for Evidence-Based Medicine and Outcomes Research, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Ambuj KumarDivision and Center for Evidence-Based Medicine and Outcomes Research, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Rahul MhaskarDivision and Center for Evidence-Based Medicine and Outcomes Research, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Benjamin DjulbegovicDivision and Center for Evidence-Based Medicine and Outcomes Research, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.

Funding

Treatment Success and Ethical Principle of EquipoiseR01CA140408 · NCI · UNIVERSITY OF SOUTH FLORIDA · PI DJULBEGOVIC, BENJAMIN · 2009 to 2010
$631k
Quality of Research on Treatment Harms in CancerR01CA133594 · NCI · UNIVERSITY OF SOUTH FLORIDA · PI DJULBEGOVIC, BENJAMIN · 2007 to 2008
$539k
Evaluation of the Quality of Clinical TrialsR01NS052956 · NINDS · H. LEE MOFFITT CANCER CTR &RES INST · PI DJULBEGOVIC, BENJAMIN · 2005 to 2006
$445k
Equipoise and the research integrity of clinical trialsR01NS044417 · NINDS · UNIVERSITY OF SOUTH FLORIDA · PI DJULBEGOVIC, BENJAMIN · 2002 to 2003
$290k
NCI NIH HHS 1R01CA133594-01NCI NIH HHS R01 CA133594NCI NIH HHS R01 CA140408NCI NIH HHS R01CA140408-01NINDS NIH HHS 1 R01 NS044417-01NINDS NIH HHS 1 R01 NS052956-01NINDS NIH HHS R01 NS052956
6 · The paper itself

Abstract

objectiveTo understand how often 'breakthroughs,' that is, treatments that significantly improve health outcomes, can be developed.

designWe applied weighted adaptive kernel density estimation to construct the probability density function for observed treatment effects from five publicly funded cohorts and one privately funded group. DATA SOURCES: 820 trials involving 1064 comparisons and enrolling 331,004 patients were conducted by five publicly funded cooperative groups. 40 cancer trials involving 50 comparisons and enrolling a total of 19,889 patients were conducted by GlaxoSmithKline.

resultsWe calculated that the probability of detecting treatment with large effects is 10% (5-25%), and that the probability of detecting treatment with very large treatment effects is 2% (0.3-10%). Researchers themselves judged that they discovered a new, breakthrough intervention in 16% of trials.

conclusionsWe propose these figures as the benchmarks against which future development of 'breakthrough' treatments should be measured.

Indexed as

BenchmarkingClinical Trials as TopicStatistics as TopicHumansNeoplasmsProbabilityTreatment OutcomeBIOTECHNOLOGY & BIOINFORMATICSEPIDEMIOLOGYSTATISTICS & RESEARCH METHODS

Identifiers

PMID25335959
PMCPMC4208055

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.