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Efficacy-effectiveness gaps in oncology: Looking beyond survival
Brooke E Wilson1,2, Timothy P Hanna1,2, Christopher M Booth1,2
1Department of Oncology, Queen's University, Kingston, Ontario, Canada.
Cancer
|November 2, 2023
Summary
The efficacy-effectiveness (EE) gap shows treatment outcomes differ between clinical trials and real-world practice. This gap impacts survival, quality of life, and costs, influencing healthcare decisions.
Area of Science:
- Health Services Research
- Clinical Trials
- Comparative Effectiveness
Background:
- The efficacy-effectiveness (EE) gap highlights discrepancies between controlled clinical trial results and real-world patient outcomes.
- This gap traditionally focuses on survival differences, potentially overlooking other critical patient and system impacts.
Purpose of the Study:
- To broaden the understanding of the EE gap beyond survival outcomes.
- To emphasize the importance of considering quality of life, toxicity, cost-effectiveness, and patient time in treatment decisions.
Main Methods:
- Review of existing evidence on EE gaps in various domains.
- Commentary on the implications of these gaps for patients, clinicians, and healthcare systems.
Main Results:
- Evidence supports the existence of EE gaps in quality of life, time toxicity, and cost-effectiveness.
- These broader EE gaps can lead to unrealistic expectations regarding therapy benefits.
Conclusions:
- The EE gap encompasses more than just survival, affecting quality of life, toxicity, and economic factors.
- Further research is crucial to fully understand and address these multifaceted EE gaps for informed clinical and healthcare policy decisions.
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