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Published on: August 1, 2019
Communicating Time-to-Event Treatment Effects in Randomized Trials: A Randomized Experiment among General
Helge Giese1,2, Wolfgang Gaissmaier2, Oliver Kuss3,4
1Heisenberg Chair for Medical Risk Literacy and Evidence-based Decisions, Charité- Universitätsmedizin Berlin, Berlin, Germany.
Summary
General practitioners struggle to interpret time-to-event treatment effects from clinical trials, regardless of presentation format. New strategies are needed to effectively communicate these complex outcomes for better patient decision-making.
Area of Science:
- Clinical Trials
- Medical Communication
- Health Outcomes Research
Background:
- Time-to-event outcomes in randomized controlled trials (RCTs) are frequently presented in ways that obscure how treatment effects change over time.
- This lack of clarity hinders clinicians' interpretation of trial results and their ability to support patient decision-making.
Purpose of the Study:
- To evaluate the understanding and acceptability of different formats for communicating time-to-event treatment effects among general practitioners.
- To determine if providing baseline risk information improves the interpretation of these effects.
Main Methods:
- An online experiment was conducted with 250 German general practitioners in April 2024.
- Participants assessed treatment effects using four common formats: hazard ratios, prolongation of life, restricted mean survival time (RMST), and absolute risk reduction.
- Understanding was measured by the ability to compare effect sizes (small, medium, large), and acceptability of each format was also assessed.
Main Results:
- Effectiveness ratings did not differ across formats for distinguishing between small, medium, and large treatment effects.
- Restricted mean survival time (RMST) presentations were rated as less effective but more acceptable compared to other formats.
- The inclusion of baseline risk information did not significantly impact effectiveness ratings or acceptability.
Conclusions:
- General practitioners experienced difficulties interpreting time-to-event treatment effects across all evaluated formats.
- No tested format facilitated an accurate understanding of effect size, even though RMST was preferred.
- Current methods for communicating time-to-event outcomes may be inadequate for clinical practice, necessitating the development of improved strategies.
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