Evidence map›Paper›PMID 33096986›Full record

ArticleBMC medical research methodology2020

Predictive approaches to heterogeneous treatment effects: a scoping review.

Alexandros Rekkas, Jessica K Paulus, Gowri Raman, John B Wong, Ewout W Steyerberg, Peter R Rijnbeek, David M Kent, David van Klaveren

Open access · goldAbstract readScoping Review
In one paragraph

Article in BMC medical research methodology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 1 pooled it
11.9field-weighted citation impact, top 1% of its field
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

27 citing papers in PubMed, 1 synthesis or guideline pooled it, 86 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Trial
  6. Article
  7. Medical Digital Twin Technology for Interoperability: Challenges and Opportunities.Biomedical engineering and computational biology · 2026
    Review
  8. Characterizing Treatment Effect Heterogeneity Using Real-World Data.Clinical pharmacology and therapeutics · 2025
    Review
  9. Article
  10. Review
  11. Article
  12. Review
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Decision Curve Analysis for Personalized Treatment Choice between Multiple Options.Medical decision making : an international journal of the Society for Medical Decision Making · 2023
    Article
  20. 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

8 authors at 3 institutions in 2 countries.

Alexandros RekkasDepartment of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.
Jessica K PaulusPredictive Analytics and Comparative Effectiveness (PACE) Center, Institute for Clinical Research and Health Policy Studies (ICRHPS), Tufts Medical Center, 800 Washington St, Box 63, Boston, MA, 02111, USA.
Gowri RamanCenter for Clinical Evidence Synthesis, ICRHPS, Tufts Medical Center, Boston, MA, USA.
John B WongDivision of Clinical Decision Making, Tufts Medical Center, Boston, MA, USA.
Ewout W SteyerbergDepartment of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.
Peter R RijnbeekDepartment of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands.
David M KentPredictive Analytics and Comparative Effectiveness (PACE) Center, Institute for Clinical Research and Health Policy Studies (ICRHPS), Tufts Medical Center, 800 Washington St, Box 63, Boston, MA, 02111, USA. dkent1@tuftsmedicalcenter.org.ORCID 0000-0002-9205-5070
David van KlaverenPredictive Analytics and Comparative Effectiveness (PACE) Center, Institute for Clinical Research and Health Policy Studies (ICRHPS), Tufts Medical Center, 800 Washington St, Box 63, Boston, MA, 02111, USA.
Tufts Medical Center · USLeiden University Medical Center · NLErasmus MC · NL

Funding

Patient-Centered Outcomes Research Institute SA.Tufts.PARC.OSCO.2018.01.25
6 · The paper itself

Abstract

backgroundRecent evidence suggests that there is often substantial variation in the benefits and harms across a trial population. We aimed to identify regression modeling approaches that assess heterogeneity of treatment effect within a randomized clinical trial.

methodsWe performed a literature review using a broad search strategy, complemented by suggestions of a technical expert panel.

resultsThe approaches are classified into 3 categories: 1) Risk-based methods (11 papers) use only prognostic factors to define patient subgroups, relying on the mathematical dependency of the absolute risk difference on baseline risk; 2) Treatment effect modeling methods (9 papers) use both prognostic factors and treatment effect modifiers to explore characteristics that interact with the effects of therapy on a relative scale. These methods couple data-driven subgroup identification with approaches to prevent overfitting, such as penalization or use of separate data sets for subgroup identification and effect estimation. 3) Optimal treatment regime methods (12 papers) focus primarily on treatment effect modifiers to classify the trial population into those who benefit from treatment and those who do not. Finally, we also identified papers which describe model evaluation methods (4 papers).

conclusionsThree classes of approaches were identified to assess heterogeneity of treatment effect. Methodological research, including both simulations and empirical evaluations, is required to compare the available methods in different settings and to derive well-informed guidance for their application in RCT analysis.

Indexed as

Research DesignHumansRandomized Controlled Trials as Topic

Identifiers

PMID33096986
PMCPMC7585220
OpenAlexW3093678378

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.