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Biostatistics Primer: What a Clinician Ought to Know: Hazard Ratios

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Presentation on theme: "Biostatistics Primer: What a Clinician Ought to Know: Hazard Ratios"— Presentation transcript:

1 Biostatistics Primer: What a Clinician Ought to Know: Hazard Ratios
Helen Barraclough, MSc, Lorinda Simms, MSc, PStat, Ramaswamy Govindan, MD  Journal of Thoracic Oncology  Volume 6, Issue 6, Pages (June 2011) DOI: /JTO.0b013e31821b10ab Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions

2 FIGURE 1 Simplistic interpretation of a hazard ratio (HR). HR = 1 means equal efficacy of the experimental (E) and control (C) treatments. If the experimental treatment is better than the control, then the HR (E versus C) <1. If the experimental treatment is worse than the control, then the HR (E versus C) >1. Journal of Thoracic Oncology 2011 6, DOI: ( /JTO.0b013e31821b10ab) Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions

3 FIGURE 2 Median survival versus the hazard ratio (HR). Kaplan-Meier (KM) curves are used to graphically describe time-to-event (survival) outcomes in randomized clinical trials (RCTs). Above is a KM curve from a hypothetical oncology RCT of two treatment (Trt) arms (Trt A and Trt B) which evaluated overall survival (OS) as the primary end point. The KM curves plot the “events” that occur in each treatment arm. For OS, death is the event so the curve drops down a “step” each time a patient dies to reflect the new probability of still being alive at that point in time in each treatment arm. The HR summarizes all the time-to-event information described by the KM survival curve. In contrast, the median survival focuses on only one point on the KM curve, that is the survival time when survival probability is 50% (shown by the dotted lines). Journal of Thoracic Oncology 2011 6, DOI: ( /JTO.0b013e31821b10ab) Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions

4 FIGURE 3 The Proportional Hazards (PH) assumption. Proportional hazards assumption holds true (A), minor violation of the PH assumption (B), and major violation of the PH assumption (C). TRT, treatment. Journal of Thoracic Oncology 2011 6, DOI: ( /JTO.0b013e31821b10ab) Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions

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