Review of survival analyses published in cancer journals
Open accessAbstract
Survival analysis has found widespread applications in medicine in the last 10-15 years. However, there has been no published review of the use and presentation of survival analyses. We have carried out a systematic review of the research papers published between October and December 1991 in five clinical oncology journals. A total of 132 papers were reviewed. We looked at several aspects of study design, data handling, analysis and presentation of the results. We found that almost half of the papers did not give any summary of length of follow-up; that in 62% of papers at least one end point was not clearly defined; and that both logrank and multivariate analyses were frequently reported at most only as P-values [63/84 (75%) and 22/47 (47%) respectively]. Furthermore, although many studies were small, uncertainty of the estimates was rarely indicated [in 13/84 (15%) logrank and 16/47 (34%) multivariate results]. The procedure for categorisation of continuous variables in logrank analyses was explained in only 8/49 (16%) papers. The quality of graphs was felt to be poor in 43/117 (37%) papers which included at least one survival curve. To address some of the presentational inadequacies found in this review we include new suggested guidelines for the presentation of survival analyses in medical journals. These would complement the statistical guidelines recommended by several clinical oncology journals.
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Almost half of 132 articles in cancer journals (mostly cohort studies) did not give any summary of length of follow-up.
“Almost half of 132 articles in cancer journals (mostly cohort studies) did not give any summary of length of follow-up [ 37 ].”
From Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration (2007) · cites this paper as [37]
The Results identify 132 papers, and the Follow-up section says almost half gave no summary of follow-up. But the Results describe 51% as clinical trials and 45% as retrospective observational studies, not mostly cohort studies. (LLM, conf=0.90)
Experimental — accuracy not yet measuredNearly 80% of 132 reports in oncology journals that used survival analysis included the starting and ending dates for accrual of patients, but only 24% also reported the date on which follow-up ended.
“Of note, nearly 80% of 132 reports in oncology journals that used survival analysis included the starting and ending dates for accrual of patients, but only 24% also reported the date on which follow-up ended [ 37 ].”
From Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration (2007) · cites this paper as [37]
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Haynes, R. B., Mulrow, C. D., Huth, E. J., Altman, D. G., & Gardner, M. J. (1990) · Annals of Internal Medicine · doi:10.7326/0003-4819-113-1-69 · Cited by 526 · see citing works
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Moher, D., Hopewell, S., Schulz, K. F., Montori, V., Gotzsche, P. C., Devereaux, P. J., Elbourne, D., Egger, M., & Altman, D. G. (2010) · BMJ · doi:10.1136/bmj.c869 · Cited by 8,883 · see citing works
Self-citationVandenbroucke, J. P., von Elm, E., Altman, D. G., Gøtzsche, P. C., Mulrow, C. D., Pocock, S. J., Poole, C., Schlesselman, J. J., Egger, M., & Initiative, F. T. S. (2007) · PLoS Medicine · doi:10.1371/journal.pmed.0040297 · Cited by 8,613 · see citing works
“Almost half of 132 articles in cancer journals (mostly cohort studies) did not give any summary of length of follow-up [37].”
Self-citationPractical methods for incorporating summary time-to-event data into meta-analysis.
Tierney, J. F., Stewart, L. A., Ghersi, D., Burdett, S., & Sydes, M. R. (2007) · Trials · doi:10.1186/1745-6215-8-16 · Cited by 6,208 · see citing works
The Revised CONSORT Statement for Reporting Randomized Trials: Explanation and Elaboration
Altman, D. G., Schulz, K. F., Moher, D., Egger, M., Davidoff, F., Elbourne, D., Gøtzsche, P. C., Lang, T., & for the CONSORT Group (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-134-8-200104170-00012 · Cited by 3,835 · see citing works
Self-citationVandenbroucke, J. P., Elm, E. V., Altman, D. G., Gøtzsche, P. C., Mulrow, C. D., Pocock, S. J., Poole, C., Schlesselman, J. J., Egger, M., & initiative, F. T. S. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-147-8-200710160-00010-w1 · Cited by 3,543 · see citing works
Self-citationVandenbroucke, J. P., von Elm, E., Altman, D. G., Gøtzsche, P. C., Mulrow, C. D., Pocock, S. J., Poole, C., Schlesselman, J. J., & Egger, M. (2014) · International Journal of Surgery · doi:10.1016/j.ijsu.2014.07.014 · Cited by 2,969 · see citing works
Self-citationVandenbroucke, J. P., von Elm, E., Altman, D. G., Gøtzsche, P. C., Mulrow, C. D., Pocock, S. J., Poole, C., Schlesselman, J. J., & Egger, M. (2007) · Epidemiology · doi:10.1097/ede.0b013e3181577511 · Cited by 2,779 · see citing works
Self-citationMoher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P. C., Devereaux, P. J., Elbourne, D., Egger, M., & Altman, D. G. (2012) · International Journal of Surgery · doi:10.1016/j.ijsu.2011.10.001 · Cited by 2,345 · see citing works
Self-citationReporting Recommendations for Tumor Marker Prognostic Studies (REMARK)
McShane, L. M., Altman, D. G., Sauerbrei, W., Taube, S. E., Gion, M., & Clark, G. M. (2005) · JNCI: Journal of the National Cancer Institute · doi:10.1093/jnci/dji237 · Cited by 2,162 · see citing works
Self-citationMoher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P. C., Devereaux, P. J., Elbourne, D., Egger, M., & Altman, D. G. (2010) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.03.004 · Cited by 1,858 · see citing works
Self-citationREporting recommendations for tumour MARKer prognostic studies (REMARK).
for the Statistics Subcommittee of the NCI-EORTC Working Group on Cancer Diagnostics, McShane, L. M., Altman, D. G., Sauerbrei, W., Taube, S. E., Gion, M., & Clark, G. M. (2005) · British Journal of Cancer · doi:10.1038/sj.bjc.6602678 · Cited by 1,394 · see citing works
Self-citationMethodological challenges in the evaluation of prognostic factors in breast cancer.
Altman, D. G., & Lyman, G. H. (1998) · Breast Cancer Research and Treatment · doi:10.1023/a:1006193704132 · Cited by 271 · see citing works
Self-citationTime-dependence of hazard ratios for prognostic factors in primary breast cancer
Hilsenbeck, S. G., Ravdin, P. M., de Moor, C. A., Chamness, G. C., Osborne, C. K., & Clark, G. M. (1998) · Breast Cancer Research and Treatment · doi:10.1023/a:1006133418245 · Cited by 237 · see citing works
Burton, A., & Altman, D. G. (2004) · British Journal of Cancer · doi:10.1038/sj.bjc.6601907 · Cited by 219 · see citing works
Collins, G. S., Omar, O., Shanyinde, M., & Yu, L.-M. (2013) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2012.06.020 · Cited by 192 · see citing works
Michiels, S., Piedbois, P., Burdett, S., Syz, N., Stewart, L., & Pignon, J.-P. (2005) · International Journal of Technology Assessment in Health Care · doi:10.1017/s0266462305050154 · Cited by 154 · see citing works
Mallett, S., Timmer, A., Sauerbrei, W., & Altman, D. G. (2010) · British Journal of Cancer · doi:10.1038/sj.bjc.6605462 · Cited by 122 · see citing works
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- Authors
- Altman, D., De Stavola, B., Love, S., & Stepniewska, K.
- Venue
- British Journal of Cancer
- Published
- 1995-08
- Volume
- 72
- Issue
- 2
- Pages
- 511-518
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC2033978
- OpenAlex
- W2039217762
- Cited by
- 438
- References
- 1
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 19 · 2023: 16 · 2022: 18 · 2021: 37 · 2020: 20 · 2019: 17 · 2018: 16 · 2017: 25 · 2016: 12 · 2015: 16 · 2014: 23 · 2013: 17 · 2012: 19
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- British Journal of Cancer (publishedVersion)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
- Keywords
- survival analysis, cancer research, statistical reporting quality, follow-up duration, log-rank test, multivariate analysis, survival curves, reporting guidelines, research design
- MeSH terms
- Analysis of Variance, Humans, Neoplasms, Survival Analysis, Guidelines as Topic
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