Caveat Medicus: It's Time to Re-Think Stratification, You May Not Be Helping.

IF 3.4 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Biomarker Insights Pub Date : 2023-01-01 DOI:10.1177/11772719231174746

Ognjen Arandjelović

{"title":"Caveat Medicus: It's Time to Re-Think Stratification, You May Not Be Helping.","authors":"Ognjen Arandjelović","doi":"10.1177/11772719231174746","DOIUrl":null,"url":null,"abstract":"Background: The focus of the present Letter is on the large and seemingly fertile body of work captured under the umbrella of 'patient stratification'.Objectives: I identify and explain a fundamental methodological flaw underlying the manner in which the development of an increasingly large number of new stratification strategies is approached.Design: I show an inherent conflict between the assumptions made, and the very purpose of stratification and its application in practice.Methods: I analyse the methodological underpinnings of stratification as presently done and draw parallels with conceptually similarly flawed precedents which are now widely recognized.Results: The highlighted flaw is shown to undermine the overarching ultimate goal of improved patient outcomes by undue fixation on an ill-founded proxy.Conclusion: I issue a call for a re-think of the problem and the processes leading to the adoption of new stratification strategies in the clinic.","PeriodicalId":47060,"journal":{"name":"Biomarker Insights","volume":"18 ","pages":"11772719231174746"},"PeriodicalIF":3.4000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10186568/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Biomarker Insights","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/11772719231174746","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The focus of the present Letter is on the large and seemingly fertile body of work captured under the umbrella of 'patient stratification'.

Objectives: I identify and explain a fundamental methodological flaw underlying the manner in which the development of an increasingly large number of new stratification strategies is approached.

Design: I show an inherent conflict between the assumptions made, and the very purpose of stratification and its application in practice.

Methods: I analyse the methodological underpinnings of stratification as presently done and draw parallels with conceptually similarly flawed precedents which are now widely recognized.

Results: The highlighted flaw is shown to undermine the overarching ultimate goal of improved patient outcomes by undue fixation on an ill-founded proxy.

Conclusion: I issue a call for a re-think of the problem and the processes leading to the adoption of new stratification strategies in the clinic.

Abstract Image

查看原文本刊更多论文

警告:是时候重新考虑分层了，你可能帮不上忙。

背景:本信函的重点是在“患者分层”的保护伞下捕获的大量看似丰富的工作。目标:我发现并解释了一个基本的方法论缺陷，这种缺陷潜藏在越来越多的新分层策略的发展方式之下。设计:我展示了所做的假设与分层的目的及其在实践中的应用之间的内在冲突。方法:我分析了分层的方法学基础，如目前所做的，并与概念上类似的有缺陷的先例，现在被广泛认可的相似之处。结果:突出的缺陷被证明破坏了改善患者预后的总体最终目标，因为过度固定在一个没有根据的代理上。结论:我呼吁重新思考这个问题和导致在临床中采用新的分层策略的过程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Biomarker Insights MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

6.00

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： An open access, peer reviewed electronic journal that covers all aspects of biomarker research and clinical applications.