Swimmers, Spider, & Waterfall Plots are everywhere in Oncology
Led by @mlythoe & Olivier
We offer an improvement in our new paper
The Iceberg Plot
Let me explain why it is preferable & teach you about all 4....
[Tweetorial]
ejcancer.com/article/S0959-…
Led by @mlythoe & Olivier
We offer an improvement in our new paper
The Iceberg Plot
Let me explain why it is preferable & teach you about all 4....
[Tweetorial]
ejcancer.com/article/S0959-…
All other plots we use in oncology
Tell you what happens AFTER you start the protocol
A swimmers plot shows when treatment was given, and when response and progression occurred for each individual
Tell you what happens AFTER you start the protocol
A swimmers plot shows when treatment was given, and when response and progression occurred for each individual
A spider plot shows the tumor size for each patient, every time they were assessed, over time.
And a waterfall plot shows you the single best subsequent scan for each assessable patient.
All these scans have issues
If you select patients with very indolent biology, a swimmers plot will not distinguish drug activity from v. slow tumor growth
If you select patients with very indolent biology, a swimmers plot will not distinguish drug activity from v. slow tumor growth
A spider plot is messy and hard to compare
A waterfall plot is the single best subsequent scan, but RECIST 1.1., uses a confirmatory scan for response, and thus, even 100% shrinkage is not always CR, and 30% is not always PR as it is fleeting
A waterfall plot is the single best subsequent scan, but RECIST 1.1., uses a confirmatory scan for response, and thus, even 100% shrinkage is not always CR, and 30% is not always PR as it is fleeting
Previously Sunny Kim (OHSU fellow on job market)
Showed waterfall plots exaggerated effect size by ~12% b/c of the aforementioned reason as well as b/c it omits people who are too sick to be assessed
jamanetwork.com/journals/jaman…
Showed waterfall plots exaggerated effect size by ~12% b/c of the aforementioned reason as well as b/c it omits people who are too sick to be assessed
jamanetwork.com/journals/jaman…
Because so many uncontrolled studies are run with massive selection filters, we felt that swimmers and waterfall plots were not good enough.
We wanted a way to visual the nature of a person's cancer biology.
How had their cancer responded and behaved with prior therapy
We wanted a way to visual the nature of a person's cancer biology.
How had their cancer responded and behaved with prior therapy
Enter the Iceberg plot
The bars above the waterline show the depth and duration of response to current therapy, and below the line shows the past history of treatment.
A short bar underwater, but long bar above water is suggestive of a special new drug
But....
The bars above the waterline show the depth and duration of response to current therapy, and below the line shows the past history of treatment.
A short bar underwater, but long bar above water is suggestive of a special new drug
But....
... A long underwater bar, and short bar above the surface is suggestive of indolent or pan-sensitive tumor biology.
Hey investors, if you are getting pitched on a new companies drug based on uncontrolled study. Ask for an iceberg plot, as it will reveal the truth
Hey investors, if you are getting pitched on a new companies drug based on uncontrolled study. Ask for an iceberg plot, as it will reveal the truth
If you enjoyed this tweetorial, follow @vkprasadlab where we will highlight our papers on health policy, evidence based appraisal, and oncology
vinayakkprasad.com/papers
ejcancer.com/article/S0959-…
vinayakkprasad.com/papers
ejcancer.com/article/S0959-…
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