The title quote has been a favorite of mine for quite a few years. It was written by Ashish Mahajan in the Lancet.
It is timely even considering it was first published in 2007. Admittedly it might have been the catalyst for a pivot to data-centric consulting and writing.
Statistics are like swim-wear—what they reveal is suggestive but what they conceal is vital. By empowering patients to critically appraise medical data, health-care professionals will pave the road towards meaningful collaboration.
A big data challenge in consultancy is having to tell a client their "baby is ugly". Data frameworks are created during pre-clinical planning and brand teams often aren't aware of the role they play in positioning or eventual marketing of an intervention or therapeutic. Discussing the limits of the wide-eyed optimism often rampant in drug discovery does not make you a popular member of the discussion. But I would argue, perhaps one of the most valuable.
Full disclosure, these are a few of the graphics I have recently used while discussing these topics with groups either bringing a drug to market, understanding the competitive landscape, or guiding stakeholders through what gets reported and what it actually means to their individual perspectives. Links are included for additional granularity.
One of the retained channels of direct physician communication remains continued medical education or CME. I continue to argue many are wasting the opportunity by relying on self-serving myopic educational offerings while simultaneously limiting data collection and analyses to the "been there, done that" mentality of whatever hegemonic framework they are promoting (monetizing).
The journey to "value-based" care is paved with vague terms like "value" and "innovation". Patients, industry, FDA, and insurance companies for example all have unique tensions around bringing innovative and effective therapies or interventions to patients as quickly as possible.
Oncology, in recent months has been the poster child of "hurry up and wait". Trials are trying to move faster with smaller patient populations often identified by pre-determined markers of success dependent on a heterogeneous group of clinical trial endpoints. How do we sift through the data and clinical findings?
...surrogates can result in market access for technologies that turn out to offer no true health benefit — or even cause harm —and can result in overestimation of treatment effects (and economic value), which can lead to inappropriate decisions on coverage.
However, the use of appropriately validated surrogate end points within a consistent framework provides substantial potential to speed up access to innovative technologies that offer important value for patients and healthcare systems and to improve efficiency and equity within the R&D environment.
Use of surrogate end points in healthcare policy: a proposal for adoption of a validation framework--Ciani, Buyse, Drummond, Rasi, Saad, and Taylor
•Can absolute standards of surrogacy be defined?
•Is association approach sufficient or should surrogacy be further explored using causal inference?
•If a surrogate is valid for a specific treatment, is it still valid for other treatments?
•Is constancy assumption reasonable (changing treatment landscape)?
•Can incomplete surrogate be used e.g. for rescue therapy?
The Surrogate Threshold Effect (STE) for EFS as potential surrogate for OS in patients treated for
Acute Myeloid Leukemia (AML)--Buyse, Schlenk, Donner, Burzykowski-- JSM 2017