Risk-difference curves can be used to communicate time-dependent effects of adjuvant therapies for early stage cancer

M Coory, K E Lamb, Michael Sorich

    Research output: Contribution to journalReview articlepeer-review

    8 Citations (Scopus)


    Objectives To describe the use of risk-difference curves for communicating time-dependent absolute treatment effects. Study Design and Setting Three examples based on individual patient data meta-analyses for adjuvant treatments for early-stage breast cancer are presented. Unit record datasets were re-created from the published Kaplan-Meier curves and numbers at risk or person-years at risk. Risk-difference curves, with corresponding 95% confidence bands, are presented and discussed. Results Risk-difference curves are useful for communicating the results from trials of adjuvant treatments for early-stage cancer when standard measures of the absolute treatment effect for survival data (ie, difference-in-mean and difference-in-median survival) can be difficult to estimate. They also avoid the problem of "evolving selection bias", which can affect interval-specific hazard ratio (HR)s in trials with long follow-up and where the participants are heterogeneous with respect to prognosis. Conclusion Clinical epidemiologists should consider reporting risk-difference curves in addition to Kaplan-Meier curves and the HR.

    Original languageEnglish
    Pages (from-to)966-972
    Number of pages7
    JournalJournal of Clinical Epidemiology
    Issue number9
    Publication statusPublished - Sept 2014


    • Absolute treatment effect
    • Difference-in-mean survival
    • Difference-in-median survival
    • Hazard ratio
    • Kaplan-Meier curves
    • Relative treatment effect
    • Risk-difference curve
    • Survival
    • Time-dependent treatment effect


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