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Counterfactual approach with survival or time to event outcomes: An application to an exhaustive cohort of Epithelial Ovarian Carcinoma in the Rhône-Alps region of France

Author

Listed:
  • Marius Huguet

    (Univ Lyon, Université Lyon 2, F-69007 Lyon, France)

  • Lionel Perrier

    (Université de Lyon, Lyon, F-69007, France ; Cancer Centre Léon Bérard; Lyon, F-69008, France ; CNRS, GATE Lyon Saint- Etienne, Ecully, F-69130, France)

  • Olivia Ballyc

    (Cancer Centre Léon Bérard; Lyon, F-69008, France)

  • Xavier Joutard

    (Grequam-UMR 7316, Aix-Marseille University, Marseille, France)

  • Nathalie Havet

    (Université de Lyon, Lyon, F-69007, France ; CNRS, GATE Lyon St Etienne,F-69130 Ecully, France)

  • Fadila Farsi

    (Réseau Espace Santé Cancer Rhône-Alpes, Lyon, France)

  • David Benayoun

    (Hospital Lyon Sud, Pierre-Bénite, France)

  • Pierre de Saint Hilaire

    (University Hospital of Lyon, Department of medicine. Lyon, France)

  • Dominique Beal Ardisson

    (Private Hospital Jean Mermoz, Lyon, France)

  • Magali Morelle

    (Université de Lyon, Lyon, F-69007, France ; Cancer Centre Léon Bérard; Lyon, F-69008, France ; CNRS, GATE Lyon Saint- Etienne, Ecully, F-69130, France)

  • LIsabelle Ray-Coquard

    (Univ Lyon, Leon Berard Cancer Centre , EA7425 HESPER, F-69008 Lyon, France)

Abstract

Epithelial Ovarian Carcinoma (EOC) is a disease with poor prognosis, most often diagnosed at an advanced stage, thus necessitating aggressive and complex surgery. The aim of this study was to compare Progression Free Survival (PFS) at 1st line treatment of EOC patients treated in high vs low-volume hospitals. This retrospective study using prospectively implemented databases was conducted on an exhaustive cohort of 267 patients treated in first line during 2012 in the Rhone-Alps Region of France. In order to control for selection bias, a multivariate analysis and the Inverse Probability Weighting (IPW) using the propensity score were adopted. An Adjusted Kaplan Meier Estimator (AKME) and a univariate Cox model in the weighted sample were then applied in order to determine the impact of the centralization of care on EOC. Patients treated in lower volume hospitals had a probability of relapse (including death) that was 1.5 times higher than for patients treated in higher volume hospitals (p=0.02). As reported in other countries, the concentration of care for EOC has a significant positive impact on patient outcomes.

Suggested Citation

  • Marius Huguet & Lionel Perrier & Olivia Ballyc & Xavier Joutard & Nathalie Havet & Fadila Farsi & David Benayoun & Pierre de Saint Hilaire & Dominique Beal Ardisson & Magali Morelle & LIsabelle Ray-Co, 2016. "Counterfactual approach with survival or time to event outcomes: An application to an exhaustive cohort of Epithelial Ovarian Carcinoma in the Rhône-Alps region of France," Working Papers 1622, Groupe d'Analyse et de Théorie Economique Lyon St-Étienne (GATE Lyon St-Étienne), Université de Lyon.
    • Handle: RePEc:gat:wpaper:1622
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    References listed on IDEAS

    as
    1. A. Smith, Jeffrey & E. Todd, Petra, 2005. "Does matching overcome LaLonde's critique of nonexperimental estimators?," Journal of Econometrics, Elsevier, vol. 125(1-2), pages 305-353.
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    More about this item

    Keywords

    Counterfactual; Disease management programme; France; Epithelial Ovarian Cancer; Propensity score; Centralization of care;
    All these keywords.

    JEL classification:

    • C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Semiparametric and Nonparametric Methods: General
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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