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Christine MH
05-24-2005, 04:43 AM
I once had a great stats prof who said that he wasn't going to make statistics easy because it already was easy. Let's see if he's right:

Hazard ratio: The lower the figure the better. For HERA the hazard ratio was .54 (54%), meaning that for every one hundred women who would have recurred without herceptin, only an estimated 54 of the recurred when herceptin was given after treatment. The risk reduction is 1 - the hazard ratio (1-.54) which is the same as 100%-54% =46%.

The 95% confidence interval. You will note that I said 'estimate' above, because there is always some uncertainty in statistics, so it's not clear whether the value is exactly 54%. For the HERA results, the 95% confidence interval was .43-.67. This means that it is 95% certain that of one hundred women who would have recurred without herceptin, only between 43 and 67 of them recurred when herceptin was given. So they are 95% certain that the risk reduction is somewhere between 33% (100%-67%) and 57% (100%-43%).

The P-value is the probability that something is purely a coincidence. If the p-value is .01 that means that there is a 1 in a hundred chance that it is a coincidence. If it is .05, there is a 5 in a hundred chance of it being a coincidence. In general, only p-values under .05 or sometimes .01 are considered statistically significant. The smaller the number the better. To demonstrate statistical significance, it is important to have a large number of cases, which brings me to HERA.

The HERA results show that the p-value for disease free survival is less than .0001. This means that the chance of this being a coincidence is less than 1 in 10,000. However, the p-value for overall survival is just .26 which means that the chance of this being a coincidence is 26%. However, HERA was not as far along as the other studies, so it may simply be too early to see a difference in overall survival, since the followup was only one year following women entering the trial. I would caution that HERA included about 1/3 node-negative women, some of whom received really old chemo drugs believed to be less effective against HER2, such as CMF, so it cannot be compared directly with the herceptin-based chemo studies.

The combined studies on herceptin-based chemo seem to have used a two-tailed test, which I am much less familiar with, but again the same rule about p-values values under .05 or 5 in 100 being good news is the same. For distant disease free survival, there is only a 1 chance in 10,000,000,000 that this is a coincidence (I think, I've never seen a p-value this small!). For overall survival, herceptin-based chemo again achieved statistical significance (.015) with there being just a 1.5 chance in 100 of this being a fluke.

Are there any other problems figuring out the stats?


Christine

Jo50
05-24-2005, 04:59 AM
Wow - certainly in plainer English than before, but still leaves my head spinning. I was never any good at anything related to maths (had to take O level twice)!! However, the gist seems to be good news. Thank you for explaining this here, and in several other posts I've seen in this and other boards. Jo

Christine MH
05-24-2005, 05:52 AM
Yes, it is very good news. Especially the herceptin-based chemo results.

It's not you, Jo. My old statistics professor was good, but he had the advantage of being able to build up to these ideas gradually. No statistics prof in his or her right mind would start out with a discussion of these terms. Many of these ideas would be covered towards the end of a university statistics course, at least for the social sciences.

By the way, the statistics class I was the teaching assistant for was a required one for social science students. It was second semester and many of them had put it off to the very last minute because they hated mathematics with a passion, but they desperately needed it to graduate. I got them through, but it was some of the hardest money I have ever earned, so I know how tough it is.

imported_Joe
05-24-2005, 10:29 AM
Project Lead sponsored by the National Breast cancer Coalition is an excellent training program for anyone who is interested in being a patient advocate and gives training in understanding clinical trial results.

Attending this project also qualifies you for a scholarship to attend the San Antonio Breast Cancer Symposium sponsored by the A;lamo Breast Cancer Foundation

National Breast Cancer Coalition Website (http://www.natlbcc.org/)

The HER2 Support Group will sponsor anyone interested in this worthwhile program.

Regards
Joe

Esther
05-24-2005, 10:53 AM
Joe:

I am interested in the project lead training. Not sure if will be able to make the Aug training or the one in November.

I will download the application and look into signing up.

Rozebud
05-25-2005, 12:29 PM
Thanks Christine. So here is how I'm intepreting it. (For those who are curious, I am 12 minutes into the Romond presentation (4th down):
http://asco.org/ac/1,1003,_12-002511-00_18...0_21-001,00.asp (http://asco.org/ac/1,1003,_12-002511-00_18-0034-00_19-005817-00_21-001,00.asp) )

Looks like the overall hazard ratio is about .5. The other significant thing is that all groups seem to benefit, and the CI's are relatively tight (except for high risk node negative, there weren't enough of those). However, if I am looking across groups.....all other things being equal (and assuming lower hazard ratio is better), it looks like the biggest lift relative to peers in that group are smaller tumor, less number of nodes, older age, and hormone positive. Is that right? I know they are slight differences, just wondering if I'm interpreting correctly.

Christine MH
05-25-2005, 03:29 PM
Dear Rozebud,

Pretty good, although I would hesitate to talk about different benefits for different groups. There is a statistical technique that could be used to show whether some groups benefitted significanlty more than others, but that has not been done here.

Best wishes,

Christine