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Reading a hazard ratio

aka hazard ratios, relative risk, risk reduction, relative risk reduction, reduced the risk of, lower risk of death, risk of death or progression, risk of progression or death

A hazard ratio of 0.70 means that at any given moment patients on the new treatment had 30% less risk of the event (death, progression) than those on the comparison. It says nothing about how many months that is worth.

The hazard ratio comes from a model that compares event rates across the entire follow-up period, not just at one time point; the confidence interval around it must exclude 1.0 for the difference to be considered statistically significant, and the closer to zero, the larger the effect. Because it is relative, the same hazard ratio can mean very different absolute gains: 0.70 might add one month to a median of three, or two years to a median of six, so it should always be read alongside the median difference and the survival curves. A hazard ratio also assumes the effect is roughly constant over time, which immunotherapy, with its delayed benefit and long tail, often violates.

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Clinic basics

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