Adjusting for Treatment Switching in Oncology Trials: A Systematic Review and Recommendations for Reporting

Thomas R. Sullivan, Nicholas R. Latimer, Jodi Gray, Michael J. Sorich, Amy B. Salter, Jonathan Karnon

Research output: Contribution to journalReview articlepeer-review

12 Citations (Scopus)


Objectives: To systematically review the quality of reporting on the application of switching adjustment approaches in published oncology trials and industry submissions to the National Institute for Health and Care Excellence Although methods such as the rank preserving structural failure time model (RPSFTM) and inverse probability of censoring weights (IPCW) have been developed to address treatment switching, the approaches are not widely accepted within health technology assessment. This limited acceptance may partly be a consequence of poor reporting on their application. Methods: Published trials and industry submissions were obtained from searches of PubMed and, respectively. The quality of reporting in these studies was judged against a checklist of reporting recommendations, which was developed by the authors based on detailed considerations of the methods. Results: Thirteen published trials and 8 submissions to satisfied inclusion criteria. The quality of reporting around the implementation of the RPSFTM and IPCW methods was generally poor. Few studies stated whether the adjustment approach was prespecified, more than a third failed to provide any justification for the chosen method, and nearly half neglected to perform sensitivity analyses. Further, it was often unclear how the RPSFTM and IPCW methods were implemented. Conclusions: Inadequate reporting on the application of switching adjustment methods increases uncertainty around results, which may contribute to the limited acceptance of these methods by decision makers. The proposed reporting recommendations aim to support the improved interpretation of analyses undertaken to adjust for treatment switching.

Original languageEnglish
Pages (from-to)388-396
Number of pages9
JournalValue in Health
Issue number3
Publication statusPublished - 1 Mar 2020


  • economic evaluation
  • statistical methods
  • survival analysis
  • technology assessment
  • treatment switching


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