PATIENT-SPECIFIC PREDICTIONS FOR CLINICAL DECISION-MAKING

There are many ways in which clinicians make decisions regarding thera py for an individual patient. Invariably, the decision is supplemented by collateral information which is obtained from clinical trials. Pro spective and retrospective clinical studies take an unnecessary advers arial position but each method has its place. Parametric survival anal ysis can product patient-specific predictions of an event of interest for an individual patient based on the risk factor profile of that pat ient, and these methods are just as applicable to prospective clinical studies as they are to retrospective clinical studies. Parametric sur vival analysis can estimate the distribution of rime to an event, esti mate the phases of hazard (instantaneous risk of the event), determine risk factors associated with the event in each of the identified phas es of risk predict the time-related probability of an event fur a spec ific patient based on his or her risk factor profile, and by risk adju stment compare the effectiveness of different therapies.