Revisiting the Relationship Between Baseline Risk and Risk Under Treatment
Author Information
Author(s): Wang Hao, Boissel Jean-Pierre, Nony Patrice
Hypothesis
The relationship between baseline risk and risk under treatment is curvilinear, suggesting that moderate-risk patients gain the most from treatment.
Conclusion
The study proposes a non-linear model indicating that moderate-risk patients benefit more from treatment compared to those at low or high risk.
Supporting Evidence
- The proposed model integrates both beneficial and harmful effects of treatment.
- Moderate-risk patients are suggested to gain the most from treatment, contrary to low or high-risk patients.
- The study highlights the need for appropriate data to understand treatment effects in high-risk patients.
Takeaway
This study suggests that patients with moderate risk get the most help from treatments, while those with very low or very high risk may not benefit as much.
Methodology
The study proposes a phenomenological model based on logistic and sigmoidal Emax models and suggests two approaches for testing the hypothesis: a meta-analysis of clinical trials and a large clinical trial with diverse risk groups.
Limitations
The results are strongly dependent on the underlying models considered, and the validity of linear extrapolation for high-risk patients remains uncertain.
Digital Object Identifier (DOI)
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