ArticlePharmacoEconomics2020
How Uncertain is the Survival Extrapolation? A Study of the Impact of Different Parametric Survival Models on Extrapolated Uncertainty About Hazard Functions, Lifetime Mean Survival and Cost Effectiveness.
Article in PharmacoEconomics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.
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
25 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Structured expert elicitation for long-term survival outcomes in health technology assessment: a systematic review.BMC medical informatics and decision making · 2025Pooled it
- A Systematic Literature Review of Modelling Approaches to Evaluate the Cost Effectiveness of PET/CT for Therapy Response Monitoring in Oncology.PharmacoEconomics · 2025Pooled it
- A Systematic Review of Methodologies Used in Models of the Treatment of Diabetes Mellitus.PharmacoEconomics · 2024Pooled it
- A Systematic Review of Methods to Incorporate External Evidence into Trial-Based Survival Extrapolations for Health Technology Assessment.Medical decision making : an international journal of the Society for Medical Decision Making · 2023Pooled it
- Structured Expert Elicitation of Long-Term Survival in Non-small Cell Lung Cancer: A Case Study Applying Guidance from NICE Technical Support Document 26.Applied health economics and health policy · 2026Article
- Structured Expert Elicitation to Inform Long-Term Survival Extrapolations in Advanced Renal Cell Carcinoma.Applied health economics and health policy · 2025Article
- Assessing time-trend bias in glioblastoma prognosis over 2 decades of clinical trials.Neuro-oncology · 2025Article
- Impact of Limited Sample Size and Follow-up on Partitioned Survival and Multistate Modeling-Based Health Economic Models: A Simulation Study.Medical decision making : an international journal of the Society for Medical Decision Making · 2025Article
- Use of propensity score matching to reduce bias in economic evaluations in the context of Brazilian liver transplantation.Einstein (Sao Paulo, Brazil) · 2025Article
- General Population Mortality Adjustment in Survival Extrapolation of Cancer Trials: Exploring Plausibility and Implications for Cost-Effectiveness Analyses in HER2-Positive Breast Cancer in Sweden.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Article
- Comparing Survival Extrapolation within All-Cause and Relative Survival Frameworks by Standard Parametric Models and Flexible Parametric Spline Models Using the Swedish Cancer Registry.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Article
- Retrospective Comparison of Survival Projections for CAR T-Cell Therapies in Large B-Cell Lymphoma.PharmacoEconomics - open · 2023Article
- Survival Extrapolation Incorporating General Population Mortality Using Excess Hazard and Cure Models: A Tutorial.Medical decision making : an international journal of the Society for Medical Decision Making · 2023Review
- Blended Survival Curves: A New Approach to Extrapolation for Time-to-Event Outcomes from Clinical Trials in Health Technology Assessment.Medical decision making : an international journal of the Society for Medical Decision Making · 2023Article
- Use of Minimal Residual Disease Status to Reduce Uncertainty in Estimating Long-term Survival Outcomes for Newly Diagnosed Multiple Myeloma Patients.Journal of health economics and outcomes research · 2023Article
- Structured expert elicitation to inform long-term survival extrapolations using alternative parametric distributions: a case study of CAR T therapy for relapsed/ refractory multiple myeloma.BMC medical research methodology · 2022Article
- Dynamic and Flexible Survival Models for Extrapolation of Relative Survival: A Case Study and Simulation Study.Medical decision making : an international journal of the Society for Medical Decision Making · 2022Article
- Informed Bayesian survival analysis.BMC medical research methodology · 2022Article
- Challenges of modelling approaches for network meta-analysis of time-to-event outcomes in the presence of non-proportional hazards to aid decision making: Application to a melanoma network.Statistical methods in medical research · 2022Article
- How Sensitive is Sensitivity Analysis?: Evaluation of Pharmacoeconomic Submissions in Korea.Frontiers in pharmacology · 2022Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
BACKGROUND AND
objectiveThe extrapolation of estimated hazard functions can be an important part of cost-effectiveness analyses. Given limited follow-up time in the sample data, it may be expected that the uncertainty in estimates of hazards increases the further into the future they are extrapolated. The objective of this study was to illustrate how the choice of parametric survival model impacts on estimates of uncertainty about extrapolated hazard functions and lifetime mean survival.
methodsWe examined seven commonly used parametric survival models and described analytical expressions and approximation methods (delta and multivariate normal) for estimating uncertainty. We illustrate the multivariate normal method using case studies based on four representative hypothetical datasets reflecting hazard functions commonly encountered in clinical practice (constant, increasing, decreasing, or unimodal), along with a hypothetical cost-effectiveness analysis.
resultsDepending on the survival model chosen, the uncertainty in extrapolated hazard functions could be constant, increasing or decreasing over time for the case studies. Estimates of uncertainty in mean survival showed a large variation (up to sevenfold) for each case study. The magnitude of uncertainty in estimates of cost effectiveness, as measured using the incremental cost per quality-adjusted life-year gained, varied threefold across plausible models. Differences in estimates of uncertainty were observed even when models provided near-identical point estimates.
conclusionsSurvival model choice can have a significant impact on estimates of uncertainty of extrapolated hazard functions, mean survival and cost effectiveness, even when point estimates were similar. We provide good practice recommendations for analysts and decision makers, emphasizing the importance of considering the plausibility of estimates of uncertainty in the extrapolated period as a complementary part of the model selection process.
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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.