Meta-analysis when only the median survival times are known: A comparison with individual patient data results

Stefan Michiels, Pascal Piedbois, Sarah Burdett, Nathalie Syz, Lesley Stewart, Jean Pierre Pignon

    Research output: Contribution to journalArticlepeer-review

    121 Citations (Scopus)

    Abstract

    Background: The hazard ratio (HR) is the most appropriate measure for time to event outcomes such as survival. In systematic reviews, HRs can be calculated either from the raw trial data obtained as part of an individual patient data (IPD) meta-analysis or from the appropriate trial-level summary statistics. However, the information required for the latter are seldom reported in sufficient detail to allow reviewers to calculate HRs. In contrast, the median survival and survival rates at specific time points are frequently presented. We aimed to evaluate retrospectively the performance of meta-analyses using median survival times and survival rates by comparing them with meta-analyses using IPD to calculate HRs. Methods: IPD from thirteen published meta-analyses (MAs) in cancers with high mortality rates were used. Median survival and survival rates were calculated from the IPD rather than taken from publications so that the same trials, patients, and extended follow-up are used in each analysis. Results and Conclusions: We show that using median survival times or survival rates at a particular point in time are not reasonable surrogate measures for meta-analyses of survival outcomes and that, wherever possible, HRs should be calculated. Individual trial publications reporting on time to event outcomes, therefore, should provide more detailed statistical information, preferably logHRs and their variances, or their estimators.

    Original languageEnglish
    Pages (from-to)119-125
    Number of pages7
    JournalInternational Journal of Technology Assessment in Health Care
    Volume21
    Issue number1
    DOIs
    Publication statusPublished - 1 Jan 2005

    Keywords

    • Median survival time
    • Meta-analysis
    • Summary data
    • Survival analysis
    • Time to event outcomes

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