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Comment & Response
October 17, 2019

Correcting the Conclusion in a Study of Frameworks for Measurement of Absolute or Clinical Benefit—In Reply

Author Affiliations
  • 1Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • 2University of Toronto, Toronto, Ontario, Canada
  • 3Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada
  • 4Cancer Care Ontario, Toronto, Ontario, Canada
JAMA Oncol. 2019;5(12):1807-1808. doi:10.1001/jamaoncol.2019.4132

In Reply We thank Dafni et al for their comments. Our intent was not to invalidate but to empirically explore the measurement characteristics of the frameworks.1 We also did not state that restricted mean survival time (RMST) is the “gold standard” measure for absolute survival. Restricted mean survival time was included in our primary analysis owing to its advantage over median survival in capturing the entire survival distribution. Recognizing that RMST is not currently widely reported, we included an additional comparison with median survival that confirmed a moderate correlation with the European Society for Medical Oncology’s preliminary magnitude of clinical benefit grades (ESMO-PMCBGs). Acknowledging that RMST calculations by reviewers may be subject to interrater variability, we advocated for direct reporting of RMST by clinical trial investigators with access to individual patient data.1

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