Truth Survival
Authors: Michael P. LaValley
Journal: Annals of Internal Medicine (2002)

Letters3 December 2002Truth SurvivalMichael P. LaValley, PhD and David T. Felson, MD, MPHMichael P. LaValley, PhDBoston University School of Medicine; Boston, MA 02118Search for more papers by this author and David T. Felson, MD, MPHBoston University School of Medicine; Boston, MA 02118Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-11-200212030-00016 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:While we applaud Poynard and colleagues for addressing the issue of truth survival in clinical research (1), we feel that the data they collected are biased and misleading. Poynard and colleagues sampled studies on cirrhosis and hepatitis from 1945 to 1999. Experts were asked if the main conclusion from each study was true, false, or obsolete as of the year 2000. False or obsolete studies were considered to have the event of interest, and studies considered still true were censored at the year 2000. With this approach, the time to event should have been the time from publication of a research study until its results became either false or obsolete. For example, studies published in 1950 and made obsolete in 1965 would have 15 years of survival. However, Poynard and colleagues determined that truth survival was the time from publication to the year 2000. Therefore, a study published in 1950 and made obsolete in 1965 would be credited with 50 years of survival rather than the correct 15 years. This systematically overestimates the truth survival of false or obsolete research.Even more problematic is that the overestimation selectively favors research with earlier publication dates, greatly inflating the truth survival of early research. Since the early research in Poynard and colleagues' sample was predominately nonrandomized, and no meta-analyses were found before 1980, it was predetermined that nonrandomized studies would appear to have greater 20-year truth survival than randomized trials or meta-analyses (87%, 85%, and 57%, respectively). Given Dr. Poynard's interest in evidence-based medicine (2), we doubt that this bias against meta-analyses and randomized trials was intentional. Indeed, Poynard and colleagues make it clear that their results were contrary to expectations. However, their data do not provide a sound basis for making this comparison.References1. Poynard T, Munteanu M, Ratziu V, Benhamou Y, Di Martino V, Taieb J, et al . Truth survival in clinical research: an evidence-based requiem? Ann Intern Med. 2002;136:888-95. [PMID: 12069563] LinkGoogle Scholar2. Poynard T, Regimbeau C, Myers RP, Thevenot T, Leroy V, Mathurin P, et al. Interferon for acute hepatitis C. Cochrane Database Syst Rev. 2002:CD000369. [PMID: 11869573] Google Scholar Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: Boston University School of Medicine; Boston, MA 02118 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTruth Survival in Clinical Research: An Evidence-Based Requiem? Thierry Poynard , Mona Munteanu , Vlad Ratziu , Yves Benhamou , Vincent Di Martino , Julien Taieb , and Pierre Opolon Truth Survival Thierry Poynard , Mona Munteanu , and Vlad Ratziu Truth Survival William C. Holmes Metrics Cited byExamining the Feasibility and Utility of Estimating Partial Expected Value of Perfect Information (via a Nonparametric Approach) as Part of the Reimbursement Decision-Making Process in Ireland: Application to Drugs for CancerValue-of-Information Analysis to Reduce Decision Uncertainty Associated with the Choice of Thromboprophylaxis after Total Hip Replacement in the Irish Healthcare SettingHirsch Index and Truth Survival in Clinical Research 3 December 2002Volume 137, Issue 11Page: 932KeywordsCirrhosisEvidence based medicineHepatitisMotivationRandomized trials ePublished: 3 December 2002 Issue Published: 3 December 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...