Emerging Themes in Epidemiology
نویسندگان
چکیده
In many areas of clinical investigation there is great interest in identifying and validating surrogate endpoints, biomarkers that can be measured a relatively short time after a treatment has been administered and that can reliably predict the effect of treatment on the clinical outcome of interest. However, despite dramatic advances in the ability to measure biomarkers, the recent history of clinical research is littered with failed surrogates. In this paper, we present a statistical perspective on why identifying surrogate endpoints is so difficult. We view the problem from the framework of causal inference, with a particular focus on the technique of principal stratification (PS), an approach which is appealing because the resulting estimands are not biased by unmeasured confounding. In many settings, PS estimands are not statistically identifiable and their degree of non-identifiability can be thought of as representing the statistical difficulty of assessing the surrogate value of a biomarker. In this work, we examine the identifiability issue and present key simplifying assumptions and enhanced study designs that enable the partial or full identification of PS estimands. We also present example situations where these assumptions and designs may or may not be feasible, providing insight into the problem characteristics which make the statistical evaluation of surrogate endpoints so
منابع مشابه
Emerging Themes in Epidemiology: Form and function
Emerging Themes in Epidemiology is a new, online Open Access journal. This editorial - which coincides with the Journal's launch - describes its unique review and publication model. The editorial board and review process of ETE will be managed by research degree students and will therefore be a training ground for students (though final editorial control rests with senior faculty Associate Edit...
متن کاملEpidemiology in conflict – A call to arms
In this first special theme issue, Emerging Themes in Epidemiology publishes a collection of articles on the theme of Epidemiology in conflict. Violent conflict is an issue of great sensitivity within public health, but more structured research and reasoned discussion will allow us to better mitigate the public health impacts of war, and place the public health community in a more informed posi...
متن کاملThe birth of Emerging Themes in Epidemiology: a tale of Valerie, causality and epidemiology
Emerging Themes in Epidemiology (ETE) is a new, online, Open Access peer-reviewed journal. The Journal is unique in that it was conceived and is managed by research degree students in epidemiology and related public health fields. The Journal's management is overseen by its Editor-in-Chief and Associate Faculty Editors, all of whom are senior members of faculty. ETE aims to encourage debate and...
متن کاملSeek, and ye shall find: Accessing the global epidemiological literature in different languages
The thematic series 'Beyond English: Accessing the global epidemiological literature' in Emerging Themes in Epidemiology highlights the wealth of epidemiological and public health literature in the major languages of the world, and the bibliographic databases through which they can be searched and accessed. This editorial suggests that all systematic reviews in epidemiology and public health sh...
متن کاملAnnual acknowledgement of manuscript reviewers 2014
The editor of Emerging Themes in Epidemiology would like to thank all our reviewers who have contributed to the journal in Volume 11 (2014).
متن کاملIndividual freedom versus collective responsibility: an ethicist's perspective
Philosophical theories of collective action have produced a number of alternative accounts of the rationality and morality of self-interest and altruism. These have obvious applications to communicable disease control, the avoidance of antibiotic resistance, the responsibility of healthcare professionals to patients with serious communicable diseases, and the sharing of personal data in epidemi...
متن کامل