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JNCI Journal of the National Cancer Institute 2005 97(14):1023-1025; doi:10.1093/jnci/dji193
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© 2005 Oxford University Press

EDITORIAL

Identification of Clinically Useful Cancer Prognostic Factors: What Are We Missing?

Lisa M. McShane, Douglas G. Altman, Willi Sauerbrei

Affiliations of authors: Biometric Research Branch, National Cancer Institute, Bethesda, MD (LMM); Cancer Research UK/NHS Centre for Statistics in Medicine, Oxford, UK (DGA); Institute for Medical Biometry and Informatics, University Hospital Freiburg, Freiburg, Germany (WS)

Correspondence to: Lisa McShane, PhD, National Cancer Institute, MSC 7434, 6130 Executive Blvd., Bethesda, MD 20892-7434 (e-mail: lm5h@nih.gov).

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The number of cancer prognostic markers that have been validated as clinically useful is pitifully small, despite decades of effort and money invested in marker research (1–3). For nearly all markers, the product has been a collection of studies that are difficult to interpret because of inconsistencies in conclusions or a lack of comparability. Small, underpowered studies; poor study design; varying and sometimes inappropriate statistical analyses; and differences in assay methods or endpoint definitions are but a few of the explanations that have been offered for this disappointing state of affairs (4–11). Researchers attempting to conduct meta-analyses of prognostic marker studies encounter many difficulties (12–14). In this issue of the Journal, . . . [Full Text of this Article]


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