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Plenary Session

1.62 Rates of Cancer Screening, BILCAP Outcry, Waterfall Plots and Response Rate, & Dr. Jeff Sharman

Plenary Session

Vinay Prasad, MD MPH

Policy, Medicine, Health, Oncology, Science & Medicine

4.8798 Ratings

🗓️ 23 May 2019

⏱️ 92 minutes

🧾️ Download transcript

Summary

We begin this episode by responding to listener feedback from episode 1.61's discussion of clinic appointment time and rates of cancer screening. We also tackle listeners' outcry over our take-down of BILCAP (spoiler alert: BILCAP is still a null trial) and how outcry like this highlights the need to train clinicians to think probabilistically. From there, we move on to discussing the recent paper by Myung Sun Kim in JAMA Network Open on waterfall plots and how they are a visual distortion of response rate. We end the episode with an interview with Dr. Jeff Sharman of Willamette Valley Cancer Institute in Eugene, Oregon on community oncology, enrolling patients in clinical trials, expertise of academia, and using real-world evidence. Waterfall plots: doi.org/10.1001/jamanetworkopen.2019.3981 Back us on Patreon! www.patreon.com/plenarysession

Transcript

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0:00.0

You're listening to Plenary Session.

0:09.4

On this episode of Plenary Session, you're in for a treat.

0:13.4

I have listener feedback from the last episode of Plenary Session, where we talked about the rates of screening over time.

0:19.4

Next, I'm back in the thick of things. I'm back in Bill Cap.

0:22.6

Just when I thought I was out, you pulled me back in. I got to discuss it yet again.

0:26.6

Because the outcry about my treatment of Bill Cap is vociferous, loud, very nearly constant,

0:32.6

but unfortunately doesn't make solid points, and that's what I hope to convince you of.

0:36.6

Finally, I'm going to talk about waterfall plots in the medical journals over time.

0:42.0

We see a lot of waterfall plots.

0:44.2

They're often Instagrammed, hashtag no filtered, but what we find is they are in fact filtered.

0:49.9

They provide a visual distortion of the response rate.

0:52.9

And I'm going to take you through data done by

0:54.9

Sonny Kim that appears now in JAMA Network Open that proves this phenomenon is true. And finally,

1:00.7

I have a far-reaching discussion with Dr. Jeff Sharman, who is a community oncologist who's

1:06.4

known for running the hematology trials of the U.S. oncology group. He's done a lot of important clinical studies.

1:12.3

I had a slight mental lapse, and I forgot two things.

1:15.8

One, the approval of a sick inhibitor, two,

1:17.7

that Venetoclax had not been tested in DLBCL.

1:20.4

I knew these two things,

1:21.6

but yet I had these momentary lapses

1:23.7

because I had been busy working very, very hard on that Saturday.

1:27.4

So, forgive me those two things.

...

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