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22-05-2019 | Clinical trial | News

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Waterfall plot diagrams may overestimate response rate

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medwireNews: Waterfall plots visually overestimate the tumor response rate to agents being tested in clinical trials, US researchers warn in JAMA Network Open.

The team found that 7% of 298 articles published in top medical journals included waterfall plots, most commonly during reporting of nonrandomized phase I and II clinical trials, whereas there was no identified use of the method in articles published in 2004.

Of the 126 oncology articles that used waterfall plots to illustrate response rate between 2016 and 2018, 97 reported the investigator-assessed overall response rate and 42 reported a centrally assessed response rate with independent review.

However, visual analysis of the waterfall plot increased the median response rate by 6.1% compared with the objective investigator-reported rate and by 12.0% compared with the central assessment rate.

“Given the widespread use of these figures in framing the discussion around cancer therapy, our findings provide an important, cautionary note,” say authors Myung Sun Kim (PeaceHealth Medical Group–Oregon, Eugene) and Vinay Prasad (Oregon Health & Science University, Portland).

By Lynda Williams

medwireNews is an independent medical news service provided by Springer Healthcare. © 2019 Springer Healthcare part of the Springer Nature group

JAMA Network Open: doi:10.1001/jamanetworkopen.2019.3981

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