Report time toxicity, the days spent in healthcare, as a standard outcome for older patients
A treatment that adds two months of life but takes up most of those days in hospitals and clinics may not be worth it to an older patient. Trials should report how many days treatment consumes.
Time toxicity, the number of days with physical healthcare contact, has been proposed as a patient-relevant outcome that is easily measurable from trial and administrative data. For older patients with limited survival, it may outweigh modest survival gains. Requiring its reporting in trials and in real-world evaluations of new therapies would inform shared decisions and could change the perceived value of some regimens.
- Older and multimorbid patients are excluded and undertreated · Most people with cancer are over 65 but most trial patients are younger and fitter. We guess how to treat the majority.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.
- Trial design, endpoints and cost · A phase 3 trial takes years and hundreds of millions of dollars, and often answers a question that has already moved on.
Pages like this
not linked directly; found by shared links- IdeaSeamless phase 2/3 with pre-registered go rules as the default for new agents
Shares Overall survival (OS), Progression-free survival (PFS), Trial design, endpoints and cost.
- IdeaTime to treatment failure and quality of life as co-primary endpoints in non-curative trials
Shares Overall survival (OS), Progression-free survival (PFS), Trial design, endpoints and cost, Toxicity and quality of life are undervalued.
- IdeaReport time toxicity, the days a treatment consumes, in every trial and decision aid
Shares Overall survival (OS), Progression-free survival (PFS), Toxicity and quality of life are undervalued.
- IdeaTolerability as a co-primary endpoint with its own label claim
Shares Progression-free survival (PFS), Trial design, endpoints and cost, Toxicity and quality of life are undervalued.
- IdeaWin-ratio endpoints that weigh survival, toxicity and quality of life together
Shares Overall survival (OS), Progression-free survival (PFS), Trial design, endpoints and cost, Toxicity and quality of life are undervalued.
- IdeaA standard handoff with medication reconciliation at every cancer care transition
Shares Older and multimorbid patients are excluded and undertreated, Toxicity and quality of life are undervalued.
- IdeaA permanent platform trial for supportive-care interventions inside cooperative groups
Shares Trial design, endpoints and cost, Toxicity and quality of life are undervalued.
- IdeaMake sponsors justify every trial exclusion of older and multimorbid patients
Shares Older and multimorbid patients are excluded and undertreated, Trial design, endpoints and cost.