Measure | Probability that a treatment is associated with: | Explicitly reflects time effect | Reflects cumulative effect over time | Requires baseline risk | Advantage | Disadvantage |
---|---|---|---|---|---|---|
Median survival | The greatest survival time when 50% patients are alive | No | Yes | Yes | Commonly used and clinically relevant; Easily summarized as statistic; May limit need for extrapolation; | Ignores what happens after 50% of subjects have experienced the event; |
Expected survival | The greatest expected survival | No | Yes | Yes | Directly relevant for cost-effectiveness; Easily summarized as statistic; | Sensitive to tail of distribution (may involve extrapolation); Does not illustrate time-varying results or time of greatest treatment effect; May not be as clinically relevant; |
Mean survival at time t | Greatest mean survival (area under the curve) up until time t | No | Yes | Yes | Limits need for extrapolation if time t corresponds to follow-up time of trial with shortest duration; Easily summarized as statistic | May be difficult to interpret; Requires subjective selection of time t; Ignores tails of distribution and does not illustrate time-varying results; |
Hazard (ratio) over time | The smallest hazard (ratio versus reference treatment) over time | Yes | No | Yes for hazard, | Directly relates to model and may help emphasize changes in treatment effect over time; | Does not capture cumulative effect of treatment over time; May lead to over interpretation near tail of distribution; Cannot be summarized as statistic (requires graphical illustration); May be more difficult to understand; |
No for hazard ratio | ||||||
Survival proportion over time (Cumulative hazard over time) | The greatest survival (proportion) over time | Yes | Yes | Yes | Highly intuitive and clinically relevant; Can be easily compared to data; | Cannot be summarized as statistic (requires graphical illustration); |
Mean survival over time | Greatest mean survival (area under the curve) over time | Yes | Yes | Yes | Reflects a cumulative summary of survival proportions up until that time point, thereby de-emphasizing tail of distribution; | Cannot be summarized as statistic (requires graphical illustration); May be more difficult to understand; |