On the use of surrogate end points in randomized trials Journal Article


Authors: Begg, C. B.; Leung, D. H. Y.
Article Title: On the use of surrogate end points in randomized trials
Abstract: In a recent paper Day and Duffy proposed a strategy for designing a randomized trial of different breast cancer screening schedules. Their strategy was based on the use of predictors of mortality determined by patients' factors at diagnosis as surrogates for true mortality. On the basis of the Prentice criterion for validity of a surrogate end point, and data from earlier studies of breast cancer case survival, they showed that, not only would the trial require a much shorter follow-up, but also that the information (i.e. inverse variance) for evaluating a treatment effect on mortality would be greater by a factor of nearly 3 if the predictors of mortality were used, compared with a trial in which mortality was actually observed. Although these results are technically correct, we believe that the conceptual strategy on which they are based is flawed, and that the fundamental problem is the Prentice criterion itself. In this paper the technical issues are discussed in detail, and an alternative structure for evaluating the validity of surrogate end points is proposed.
Keywords: randomized trials; surrogate end points
Journal Title: Journal of the Royal Statistical Society. Series A - Statistics in Society
Volume: 163
Issue: 1
ISSN: 0964-1998
Publisher: Wiley Blackwell  
Date Published: 2000-01-01
Start Page: 15
End Page: 28
Language: English
PROVIDER: scopus
DOI: 10.1111/1467-985X.00153
DOI/URL:
Notes: Export Date: 18 November 2015 -- Source: Scopus
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  1. Colin B Begg
    306 Begg
  2. Denis Heng Yan Leung
    114 Leung