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In Reply Dr Braithwaite notes the similarities between our proposed concept of lag time to benefit and the concept of payoff time. We absolutely agree.
Both concepts recognize that for many interventions, the harms occur before the benefits. Thus, both concepts strive to determine which patients are most likely to benefit from the intervention by comparing a patient’s life expectancy with the intervention’s time to benefit. Although we presented the lag time to benefit as a fixed property of the intervention, the payoff time attempts to individualize the time to benefit by incorporating an individual patient’s risk factors, potentially leading to a more accurate, individualized estimate of the time to benefit.
Lee SJ, Leipzig RM, Walter LC. Lag Time to Benefit for Preventive Therapies—Reply. JAMA. 2014;311(15):1567-1568. doi:10.1001/jama.2014.2325