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Crossover RPSFT — SCE Medical Oncology MCQ

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HardClinical Trials & StatisticsCrossover RPSFTSCE Medical Oncology

A trial allows control-arm crossover to the experimental drug at progression. Unadjusted OS HR 0.85 (p=0.08). Crossover-adjusted HR 0.70 (p=0.01). What happened?

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Correct answer: ECrossover diluted the OS benefit; RPSFT/IPCW adjustment estimates the true treatment effect had crossover not occurred — NICE considers adjusted analyses when ITT OS is confounded

Crossover gives control patients the experimental drug, diluting ITT OS difference. RPSFT/IPCW methods estimate counterfactual OS. NICE explicitly considers these in technology appraisals.

Reference: JRCPTB; NICE Methods Guide; Latimer et al Med Decis Making 2014