Investigating the impact of treatment sequences in cancers
Research type
Research Study
Full title
Investigating the Application of Causal Inference Methods for Modelling the Impact of Treatment Sequences in Health Economic Evaluations: Utilising Real-world Evidence from the English Cancer Registry
IRAS ID
294317
Contact name
Jen-Yu Amy Chang
Contact email
Sponsor organisation
University of Sheffied
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
Note: This study is a part of Jen-Yu Amy Chang's PhD project.
Patients can sometimes receive a series of treatments in a sequence instead of a single line of therapy. Alternating the order of treatments may result in different overall effectiveness and costs of medical treatments. Thus, it is important to consider the sequence of treatments when making health resource allocation decisions, particularly for cancer treatments as they usually have an impact on patient’s survival.Treatment effects are usually compared in clinical trials. However, a major limitation of clinical trial is that it often does not provide details about patients’ treatment history nor subsequent treatments. In this case, analysing routine health care data may help provide better understanding on the effect of sequential treatments and reflect local clinical practice.
Analysing routine health care data without proper adjustments may lead to incorrect results, which are incomparable to those in clinical trials. This is because patients treated at routine practice were not randomised to receive different treatments. Therefore, several large international initiatives have been investigating methods with regards to obtaining reliable treatment effects using routine health care data to assist clinical decision. This generally involves replicating clinical trial results using routine health care data and further extrapolating the results to a wider population.
To date, none of the aforementioned studies have examined the scenario of comparing the effectiveness of sequential treatments but single lines of treatments using routine health care data. Additionally, most of these studies were conducted in a non-UK setting. Thus, our project aims to fill this knowledge gap with two case studies comparing the effectiveness of different sequential treatments in treating prostate cancer and kidney cancer patients in the NHS. Specifically, we plan to replicate results of two clinical trials using the UK National Cancer Registration and Analysis Service (NCRAS) data.
REC name
London - Brent Research Ethics Committee
REC reference
21/PR/0908
Date of REC Opinion
12 Jul 2021
REC opinion
Favourable Opinion