Observational studyPharmacoepidemiology and drug safety2019
An evaluation of the impact of missing deaths on overall survival analyses of advanced non-small cell lung cancer patients conducted in an electronic health records database.
Observational study in Pharmacoepidemiology and drug safety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 31 papers.
What it found
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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
31 citing papers in PubMed.
- Comparison of epcoritamab, lenalidomide, and rituximab versus usual care in relapsed/refractory follicular lymphoma.Oncoimmunology · 2026Trial
- Using Electronic Health Records to Derive Control Arms for Early Phase Single-Arm Lung Cancer Trials: Proof-of-Concept in Randomized Controlled Trials.Clinical pharmacology and therapeutics · 2020Trial
- Augmenting fact and date of death in electronic health records using internet media sources: a validation study from two large healthcare systems.American journal of epidemiology · 2026Article
- Sociodemographic, health-related, and clinical characteristics and their associations with mortality among All of Us participants compared with the United States general population.American journal of epidemiology · 2025Article
- Real-World Germline BRCA Testing, Poly(ADP-ribose) Polymerase Inhibitor Utilization, and Survival Outcomes in Human Epidermal Growth Factor Receptor 2-Negative Metastatic Breast Cancer.JCO precision oncology · 2025Article
- Epidemiology, resource use, and treatment patterns of locally advanced or metastatic urothelial carcinoma in France.Future oncology (London, England) · 2025Article
- A Multisite Demonstration of Shared Access to Older Adults' Patient Portals.JAMA network open · 2025Article
- Long-Term Real-World Survival of Immunotherapy Compared to Chemotherapy for Metastatic Nonsmall Cell Lung Cancer: A Propensity Score-Matched Analysis.Thoracic cancer · 2025Observational
- Examining the Effect of Missing Data and Unmeasured Confounding on External Comparator Studies: Case Studies and Simulations.Drug safety · 2024Article
- The impact of different censoring methods for analyzing survival using real-world data with linked mortality information: a simulation study.BMC medical research methodology · 2024Article
- Comparing prospectively assigned trial and real-world lung cancer patients.Journal of comparative effectiveness research · 2024Article
- Systematic analysis of off-label and off-guideline cancer therapy usage in a real-world cohort of 165,912 US patients.Cell reports. Medicine · 2024Article
- Real-world survival of patients treated with taxane therapy after exposure to immunotherapy and platinum-based chemotherapy for advanced non-small-cell lung cancer without actionable mutations.ESMO real world data and digital oncology · 2024Article
- Real-world outcomes on platinum-containing chemotherapy forFrontiers in oncology · 2024Article
- Real-World Treatment Patterns and Outcomes of First-Line Immunotherapy Among Patients With Advanced Nonsquamous NSCLC HarboringJTO clinical and research reports · 2023Article
- First-Line Pembrolizumab Plus Chemotherapy for Advanced Squamous NSCLC: Real-World Outcomes at U.S. Oncology Practices.JTO clinical and research reports · 2023Article
- The design and evaluation of hybrid controlled trials that leverage external data and randomization.Nature communications · 2022Article
- Estimating survival parameters under conditionally independent left truncation.Pharmaceutical statistics · 2022Article
- A Review of Causal Inference for External Comparator Arm Studies.Drug safety · 2022Review
- Systematic pan-cancer analysis of mutation-treatment interactions using large real-world clinicogenomics data.Nature medicine · 2022Article
Corrections and comments
- Commented on by
- Erratum issuedCORRIGENDUM.2019
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this study was to assess the impact of missing death data on survival analyses conducted in an oncology EHR-derived database.
methodsThe study was conducted using the Flatiron Health oncology database and the National Death Index (NDI) as a gold standard. Three analytic frameworks were evaluated in advanced non-small cell lung cancer (aNSCLC) patients: median overall survival [mOS]), relative risk estimates conducted within the EHR-derived database, and "external control arm" analyses comparing an experimental group augmented with mortality data from the gold standard to a control group from the EHR-derived database only. The hazard ratios (HRs) obtained within the EHR-derived database (91% sensitivity) and the external control arm analyses, were compared with results when both groups were augmented with mortality data from the gold standard. The above analyses were repeated using simulated lower mortality sensitivities to understand the impact of more extreme levels of missing deaths.
resultsBias in mOS ranged from modest (0.6-0.9 mos.) in the EHR-derived cohort with (91% sensitivity) to substantial when lower sensitivities were generated through simulation (3.3-9.7 mos.). Overall, small differences were observed in the HRs for the EHR-derived cohort across comparative analyses when compared with HRs obtained using the gold standard data source. When only one treatment arm was subject to estimation bias, the bias was slightly more pronounced, but increased substantially when lower sensitivities were simulated.
conclusionsThe impact on survival analysis is minimal with high mortality sensitivity with only modest impact associated within external control arm applications.
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