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Assessment of Accuracy of Waterfall Plot Representations of Response Rates in Cancer Treatment Published in Medical Journals
IMPORTANCE: Response rates are a well-recognized outcome of clinical trials and provide an objective measure of drug activity. OBJECTIVES: To quantify the difference between objective response rate and visual representation of response in waterfall plots in recent articles in major medical journals...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Medical Association
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537809/ https://www.ncbi.nlm.nih.gov/pubmed/31099871 http://dx.doi.org/10.1001/jamanetworkopen.2019.3981 |
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author | Kim, Myung Sun Prasad, Vinay |
author_facet | Kim, Myung Sun Prasad, Vinay |
author_sort | Kim, Myung Sun |
collection | PubMed |
description | IMPORTANCE: Response rates are a well-recognized outcome of clinical trials and provide an objective measure of drug activity. OBJECTIVES: To quantify the difference between objective response rate and visual representation of response in waterfall plots in recent articles in major medical journals and to assess the change in frequency over time with which waterfall plots are used. DESIGN, SETTING, AND PARTICIPANTS: In a cross-sectional study, original articles of 6 top journals between July 2016 and June 2018 were manually reviewed to identify articles including a waterfall plot to describe a treatment effect of cancer therapy. Response rates visually represented in waterfall plots were compared with response rates reported as study outcomes. The number of original articles with a waterfall plot as a percentage of total original articles was evaluated, sampling articles from January, February, and March for the years 2004, 2008, 2012, 2016, and 2018. MAIN OUTCOMES AND MEASURES: Difference between response rates depicted in waterfall plots and response rates reported as study outcomes. RESULTS: One hundred twenty-six articles were selected for analysis. Of the 97 articles reporting investigator-assessed response rates, waterfall plots showed response rates a median (interquartile range) of 6.1% (1.8%-12.0%) higher than rates derived from investigator assessment. Forty-two articles reported response rates based on central assessment as an outcome, and waterfall plots showed response rates a median (interquartile range) of 12.0% (7.7%-18.5%) higher compared with centrally assessed response rates. The estimated percentage of original articles using waterfall plots increased from 0% in 2004 to 7% in 2018. CONCLUSIONS AND RELEVANCE: This study suggests that waterfall plots are becoming more common in oncology literature. Waterfall plots provide a visual overestimate of response rate of cancer therapies and should be evaluated with caution. |
format | Online Article Text |
id | pubmed-6537809 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | American Medical Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-65378092019-06-12 Assessment of Accuracy of Waterfall Plot Representations of Response Rates in Cancer Treatment Published in Medical Journals Kim, Myung Sun Prasad, Vinay JAMA Netw Open Original Investigation IMPORTANCE: Response rates are a well-recognized outcome of clinical trials and provide an objective measure of drug activity. OBJECTIVES: To quantify the difference between objective response rate and visual representation of response in waterfall plots in recent articles in major medical journals and to assess the change in frequency over time with which waterfall plots are used. DESIGN, SETTING, AND PARTICIPANTS: In a cross-sectional study, original articles of 6 top journals between July 2016 and June 2018 were manually reviewed to identify articles including a waterfall plot to describe a treatment effect of cancer therapy. Response rates visually represented in waterfall plots were compared with response rates reported as study outcomes. The number of original articles with a waterfall plot as a percentage of total original articles was evaluated, sampling articles from January, February, and March for the years 2004, 2008, 2012, 2016, and 2018. MAIN OUTCOMES AND MEASURES: Difference between response rates depicted in waterfall plots and response rates reported as study outcomes. RESULTS: One hundred twenty-six articles were selected for analysis. Of the 97 articles reporting investigator-assessed response rates, waterfall plots showed response rates a median (interquartile range) of 6.1% (1.8%-12.0%) higher than rates derived from investigator assessment. Forty-two articles reported response rates based on central assessment as an outcome, and waterfall plots showed response rates a median (interquartile range) of 12.0% (7.7%-18.5%) higher compared with centrally assessed response rates. The estimated percentage of original articles using waterfall plots increased from 0% in 2004 to 7% in 2018. CONCLUSIONS AND RELEVANCE: This study suggests that waterfall plots are becoming more common in oncology literature. Waterfall plots provide a visual overestimate of response rate of cancer therapies and should be evaluated with caution. American Medical Association 2019-05-17 /pmc/articles/PMC6537809/ /pubmed/31099871 http://dx.doi.org/10.1001/jamanetworkopen.2019.3981 Text en Copyright 2019 Kim MS et al. JAMA Network Open. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the CC-BY License. |
spellingShingle | Original Investigation Kim, Myung Sun Prasad, Vinay Assessment of Accuracy of Waterfall Plot Representations of Response Rates in Cancer Treatment Published in Medical Journals |
title | Assessment of Accuracy of Waterfall Plot Representations of Response Rates in Cancer Treatment Published in Medical Journals |
title_full | Assessment of Accuracy of Waterfall Plot Representations of Response Rates in Cancer Treatment Published in Medical Journals |
title_fullStr | Assessment of Accuracy of Waterfall Plot Representations of Response Rates in Cancer Treatment Published in Medical Journals |
title_full_unstemmed | Assessment of Accuracy of Waterfall Plot Representations of Response Rates in Cancer Treatment Published in Medical Journals |
title_short | Assessment of Accuracy of Waterfall Plot Representations of Response Rates in Cancer Treatment Published in Medical Journals |
title_sort | assessment of accuracy of waterfall plot representations of response rates in cancer treatment published in medical journals |
topic | Original Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537809/ https://www.ncbi.nlm.nih.gov/pubmed/31099871 http://dx.doi.org/10.1001/jamanetworkopen.2019.3981 |
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