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Lead-Time Bias

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1. Quantifying lead time bias when estimating patient survival in preemptive living kidney donor transplantation. (Abstract)

Quantifying lead time bias when estimating patient survival in preemptive living kidney donor transplantation. Preemptive kidney transplantation is the preferred initial renal replacement therapy, by avoiding dialysis and reportedly maximizing patient survival. Lead time bias may account for some or all of the observed survival advantage, but the impact of this has not been quantified. Using the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, we included adult recipients (...) of living donor kidney transplants during 1998-2017. Patients were transplanted preemptively (n = 1435) or after receiving up to 6 months of dialysis (n = 712). We created a matched cohort using propensity scores, and accounted for lead time (dialysis and estimated predialysis) using left-truncated Cox models with the primary outcome of patient survival. The median eGFR at transplantation was 6.9 mL/min per 1.73 m2 in the non-pre-emptive, and 9.6 mL/min per 1.73 m2 in the preemptive group

2019 American Journal of Transplantation

2. Impact of Hepatocellular Carcinoma Etiology and Liver Function on the Benefit of Surveillance: a Novel Approach for the Adjustment of Lead-time Bias. (Abstract)

Impact of Hepatocellular Carcinoma Etiology and Liver Function on the Benefit of Surveillance: a Novel Approach for the Adjustment of Lead-time Bias. Surveillance reportedly has benefit on survival in patients with hepatocellular carcinoma (HCC), even after adjustment for lead-time bias. However, previous adjustment for lead-time bias using tumour volume doubling time (TVDT) had inherent problem in accuracy. We evaluated survival benefit of HCC surveillance with newly developed approach (...) for adjusting lead-time bias. In addition, survival benefit was evaluated according to HCC aetiology and liver function.A total of 3899 patients were studied. TVDT was calculated in 255 study patients with ≥2 tumour size measurements before the diagnosis of HCC. Adjusted survival time was calculated based on TVDT, as the time from when HCC was assumed to be 5 mm to death or last follow-up. Survival rates based on this adjusted survival time were compared between the surveillance and nonsurveillance groups

2018 Liver International

3. Effect of glomerular filtration rate at dialysis initiation on survival in patients with advanced chronic kidney disease: what is the effect of lead-time bias? Full Text available with Trip Pro

Effect of glomerular filtration rate at dialysis initiation on survival in patients with advanced chronic kidney disease: what is the effect of lead-time bias? Current clinical guidelines recommend to initiate dialysis in the presence of symptoms or signs attributable to kidney failure, often with a glomerular filtration rate (GFR) of 5-10 mL/min/1.73 m2. Little evidence exists about the optimal kidney function to start dialysis. Thus far, most observational studies have been limited by lead (...) -time bias. Only a few studies have accounted for lead-time bias, and showed contradictory results. We examined the effect of GFR at dialysis initiation on survival in chronic kidney disease patients, and the role of lead-time bias therein. We used both kidney function based on 24-hour urine collection (measured GFR [mGFR]) and estimated GFR (eGFR).A total of 1,143 patients with eGFR data at dialysis initiation and 852 patients with mGFR data were included from the NECOSAD cohort. Cox regression

2017 Clinical epidemiology

4. Lead-Time Bias

Lead-Time Bias Lead-Time Bias Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Lead-Time Bias Lead-Time Bias Aka: Lead-Time Bias (...) diagnosis falsely appears to prolong survival Screened and unscreened patients each survive 7 years Screened patients know diagnosis 2 years earlier IV. References Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Lead-Time Bias." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Epidemiology About FPnotebook.com is a rapid access, point

2018 FP Notebook

5. Does lead-time bias have a place in court?

Does lead-time bias have a place in court? Does lead-time bias have a place in court? Does lead-time bias have a place in court? | | January 3, 2017 46 Shares In 2014, a jury in Massachusetts awarded in damages to the daughter of a Bostonian lady who died from lung cancer at 47 for a missed cancer on a chest X-ray. The verdict reminds me of the words of John Bradford, a heretic who was burned at the stake: “There, but for the grace of God, go I.” Many radiologists will sympathize with both (...) . This is known as “lead-time bias,” where early detection means more time knowing that one has the cancer, not more time one is alive. This means that had the nodule been seen on the patient’s initial chest X-ray she would probably — though not certainly — not have survived much beyond 47. Lead-time bias is a fundamental concept in the statistics of screening. Physicians have it drilled in them. Recognition of this artifact curbs therapeutic and screening optimism. Why does lead-time bias not enter

2017 KevinMD blog

6. Lead-Time Bias and Interhospital Transfer after Injury: Trauma Center Admission Vital Signs Underpredict Mortality in Transferred Trauma Patients. Full Text available with Trip Pro

Lead-Time Bias and Interhospital Transfer after Injury: Trauma Center Admission Vital Signs Underpredict Mortality in Transferred Trauma Patients. Admission physiology predicts mortality after injury, but may be improved by resuscitation before transfer. This phenomenon, which has been termed lead-time bias, may lead to underprediction of mortality in transferred patients and inaccurate benchmarking in centers receiving large numbers of transfer patients. We sought to determine the impact

2016 Journal of the American College of Surgeons

7. MiniStatsBlog: Lead time bias

MiniStatsBlog: Lead time bias StatsMiniBlog: Lead time bias | ADC Online Blog by This is a cracking cartoon that highlights everything that’s misleading about lead time bias. And will also lead to the terrible situation of the parents of the bird having to try to keep it away until proper bedtime to stop this happening tomorrow too. Lead time bias is the apparent improvement in duration of a condition (often length of survival or time to relapse) without actually changing the age at death

2015 ADC Blog

8. Estimation of loss of quality-adjusted life expectancy (QALE) for patients with operable versus inoperable lung cancer: Adjusting quality-of-life and lead-time bias for utility of surgery. Full Text available with Trip Pro

Estimation of loss of quality-adjusted life expectancy (QALE) for patients with operable versus inoperable lung cancer: Adjusting quality-of-life and lead-time bias for utility of surgery. This study attempts to quantify the difference in loss of quality-adjusted life expectancy (QALE) for patients with operable and inoperable non-small-cell lung cancer (NSCLC).A cohort consisting of 1652 pathologically verified NSCLC patients with performance status 0-1 was monitored for 7 years (2005-2011 (...) , after adjustment for QoL and lead-time bias.The utility gained from surgical operation for operable lung cancer is substantial, even after adjustment for lead-time bias. Future studies should compare screening programs with treatment strategies when carrying out cost-utility assessments to improve patients' values.Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

2014 Lung Cancer

9. Estimation of lead-time bias and its impact on the outcome of surveillance for the early diagnosis of hepatocellular carcinoma. (Abstract)

Estimation of lead-time bias and its impact on the outcome of surveillance for the early diagnosis of hepatocellular carcinoma. Lead-time is the time by which diagnosis is anticipated by screening/surveillance with respect to the symptomatic detection of a disease. Any screening program, including surveillance for hepatocellular carcinoma (HCC), is subject to lead-time bias. Data regarding lead-time for HCC are lacking. Aims of the present study were to calculate lead-time and to assess its (...) was 32.7% in semiannually surveilled patients, 25.2% in annually surveilled patients, and 12.2% in symptomatic patients (p<0.001). In a 10-year follow-up perspective, the median lead-time calculated for all surveilled patients was 6.5 months (7.2 for semiannual and 4.1 for annual surveillance). Lead-time bias accounted for most of the surveillance benefit until the third year of follow-up after HCC diagnosis. However, even after lead-time adjustment, semiannual surveillance maintained a survival

2014 Journal of Hepatology

10. Quantifying Lead-Time Bias in Risk-Factor Studies of Cancer through Simulation Full Text available with Trip Pro

Quantifying Lead-Time Bias in Risk-Factor Studies of Cancer through Simulation Lead-time is inherent in early detection and creates bias in observational studies of screening efficacy, but its potential to bias effect estimates in risk factor studies is not always recognized. We describe a form of this bias that conventional analyses cannot address and develop a model to quantify it.Surveillance Epidemiology and End Results (SEER) data form the basis for estimates of age-specific preclinical (...) incidence, and log-normal distributions describe the preclinical duration distribution. Simulations assume a joint null hypothesis of no effect of either the risk factor or screening on the preclinical incidence of cancer, and then quantify the bias as the risk-factor odds ratio (OR) from this null study. This bias can be used as a factor to adjust observed OR in the actual study.For this particular study design, as average preclinical duration increased, the bias in the total-physical activity

2013 Annals of Epidemiology

11. A mathematical model of case-ascertainment bias: Applied to case-control studies nested within a randomized screening trial. Full Text available with Trip Pro

A mathematical model of case-ascertainment bias: Applied to case-control studies nested within a randomized screening trial. When some individuals are screen-detected before the beginning of the study, but otherwise would have been diagnosed symptomatically during the study, this results in different case-ascertainment probabilities among screened and unscreened participants, referred to here as lead-time-biased case-ascertainment (LTBCA). In fact, this issue can arise even in risk-factor (...) studies nested within a randomized screening trial; even though the screening intervention is randomly allocated to trial arms, there is no randomization to potential risk-factors and uptake of screening can differ by risk-factor strata. Under the assumptions that neither screening nor the risk factor affects underlying incidence and no other forms of bias operate, we simulate and compare the underlying cumulative incidence and that observed in the study due to LTBCA. The example used

2018 PLoS ONE

12. Lead-Time Bias

Lead-Time Bias Lead-Time Bias Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Lead-Time Bias Lead-Time Bias Aka: Lead-Time Bias (...) diagnosis falsely appears to prolong survival Screened and unscreened patients each survive 7 years Screened patients know diagnosis 2 years earlier IV. References Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Lead-Time Bias." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Epidemiology About FPnotebook.com is a rapid access, point

2015 FP Notebook

13. Mean Bias in Seasonal Forecast Model and ENSO Prediction Error Full Text available with Trip Pro

Mean Bias in Seasonal Forecast Model and ENSO Prediction Error This study uses retrospective forecasts made using an APEC Climate Center seasonal forecast model to investigate the cause of errors in predicting the amplitude of El Niño Southern Oscillation (ENSO)-driven sea surface temperature variability. When utilizing Bjerknes coupled stability (BJ) index analysis, enhanced errors in ENSO amplitude with forecast lead times are found to be well represented by those in the growth rate estimated (...) by the BJ index. ENSO amplitude forecast errors are most strongly associated with the errors in both the thermocline slope response and surface wind response to forcing over the tropical Pacific, leading to errors in thermocline feedback. This study concludes that upper ocean temperature bias in the equatorial Pacific, which becomes more intense with increasing lead times, is a possible cause of forecast errors in the thermocline feedback and thus in ENSO amplitude.

2017 Scientific reports

14. The Lead Time Tradeoff: The Case of Health States Better Than Dead. Full Text available with Trip Pro

The Lead Time Tradeoff: The Case of Health States Better Than Dead. Lead time tradeoff (L-TTO) is a variant of the time tradeoff (TTO). L-TTO introduces a lead period in full health before illness onset, avoiding the need to use 2 different procedures for states better and worse than dead. To estimate utilities, additive separability is assumed. We tested to what extent violations of this assumption can bias utilities estimated with L-TTO.A sample of 500 members of the Spanish general

2014 Medical Decision Making

15. Influenced from the start: anchoring bias in time trade-off valuations Full Text available with Trip Pro

as anchoring bias. The aim of the study was to explore the potential anchoring effect and its magnitude in TTO experiments.A total of 1249 respondents valued 8 EQ-5D health states in a Web study. We used the lead time TTO (LT-TTO) which allows eliciting negative and positive values with a uniform method. Respondents were randomized to 11 different SPs. Anchoring bias was assessed using OLS regression with SP as the independent variable. In a secondary experiment, we compared two different SPs in the UK EQ (...) Influenced from the start: anchoring bias in time trade-off valuations The de facto standard method for valuing EQ-5D health states is the time trade-off (TTO), an iterative choice procedure. The TTO requires a starting point (SP), an initial offer of time in full health which is compared to a fixed offer of time in impaired health. From the SP, the time in full health is manipulated until preferential indifference. The SP is arbitrary, but may influence respondents, an effect known

2016 Quality of Life Research

16. Haemodialysis

it provides significant solute and fluid removal, and is associated with improved quality of life and survival [7]. The literature on incremental schedules is limited in particular by its observational nature, with inherent problems of selection and lead-time bias. Variation also exists in the definition of incremental dialysis, which is frequently defined as twice-weekly, without reference to residual function. Clinician bias may also be important: clinicians working in the 1990s will remember twice

2019 Renal Association

17. The Use of Bronchoscopy During the COVID-19 Pandemic: CHEST/AABIP Guideline and Expert Panel Report

was ?rst identi?ed (eg, symptoms vs imaging vs tissue diagnosis), which interval was relevant (eg, symptoms to treatment vs diagnosis to treatment), heterogeneity in populations (eg, surgically treated vs all patients with lung cancer), differences in histology (eg, all types vs non-small cell lung cancer), intractable problems because of residual confounding within groups, confounding by indication (eg, sicker patients seen more rapidly), selection bias, and failure to adjust for lead time bias (eg (...) of 80%) for each PICO question, whichever came ?rst. To maintain complete transparency and limit bias from interaction among members, additional discussions outside of the scheduled meetings before voting were discouraged. The survey incorporated the suggestions developed by all panelists and was developed and reviewed by chairs and methodologists and sent to all panel members by a CHEST-designated project coordinator. The project coordinator tallied and reported the results of the survey

2020 American College of Chest Physicians

18. Management of hepatocellular carcinoma

change the estimate. Low Small studies, retrospective observational studies, registries. Any estimate of effect is uncertain. Recommendations y Grade Wordingassociatedwiththe grade of recommendation strong ‘‘must”, ‘‘should”, or ‘‘EASL recommends” weak ‘‘can”, ‘‘may”, or ‘‘EASL suggests” * Level was graded down if there is a poor quality, strong bias or inconsistency between studies; Level was graded up if there is a large effect size. y Recommendations were reached by consensus of the panel (...) survival bene?t in favour of LR with respect to non-surgical loco-regional treatments has been observed across all stages of tumour presentation. 358 Regrettably, these retrospective comparisons were almost cer- tainly associated with selection bias, as the patients who were selectedforresectionoverTACEprobablyhadclinicalcharacter- istics that gave the surgeon con?dence of a good outcome, whereas those selected for TACE likely lacked such features, immediatelyintroducingabiasagainstTACE.InBCLC

2018 European Association for the Study of the Liver

20. Patient-centered Outcomes Research in Pulmonary, Critical Care, and Sleep Medicine: A Workshop Report

patientengagementinresearch(33)andhow to identify metrics of success (34, 35). Engaging patients in the design of studies can require more “lead-time” and may increase the cost of preparing research proposals. A challenge for researchers is the need to prioritize funding considerations to support a speci?c project while balancing thedesiretoactivelyinvolvepatientresearch partners and stakeholders within the demandsofaresearchsetting.Attimes,these competing priorities can be at odds (...) to help maintain equipoise. As not all participants will come with a similar understanding of the scienti?c process including mitigation of bias, it is important to identify, discuss, and address potential con?icts of interest (27). Similarly, it can be helpful to develop an understanding with individuals that not all ideas or suggestions will be part of the ?nal product. Being transparent about this from the beginning can help frame expectations. Prepare and train stakeholders for their various roles

2019 American Thoracic Society

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