Evaluating the Trade-off between Quantity and Quality of Life through Quality-Adjusted Survival Analysis

Clinical trials often employ many different endpoints to evaluate the benefits and risks associated with treatment. These endpoints, however, may not always align with one another. In oncology studies, for instance, a more efficacious treatment, which prolongs survival, may also be associated with greater toxicity, which decreases quality of life. Quality-adjusted survival analysis (QASA) provides a useful tool to calculate summary measures that incorporate both survival and overall quality of life so that the trade-off can be compared across treatments. Topics to be covered include construction of quality-adjusted Kaplan-Meier curves, calculation of quality-adjusted life years (QALYs), and examination of an exploratory method to evaluate quality-adjusted median survival.