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

Marius Huguet, Lionel Perrier, Olivia Ballyc, Xavier Joutard, Nathalie Havet (), Fadila Farsi, David Benayoun, Pierre de Saint Hilaire, Dominique Beal Ardisson, Magali Morelle () and Isabelle Ray-Coquard
Additional contact information
Marius Huguet: Univ Lyon, Université Lyon 2, F-69007 Lyon, France
Olivia Ballyc: Cancer Centre Léon Bérard; Lyon, F-69008, France
Xavier Joutard: Grequam-UMR 7316, Aix-Marseille University, Marseille, 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
Isabelle Ray-Coquard: Univ Lyon, Leon Berard Cancer Centre , EA7425 HESPER, F-69008 Lyon, France

No 1622, Working Papers from Groupe d'Analyse et de Théorie Economique Lyon St-Étienne (GATE Lyon St-Étienne), Université de Lyon

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.

Keywords: Counterfactual; Disease management programme; France; Epithelial Ovarian Cancer; Propensity score; Centralization of care (search for similar items in EconPapers)
JEL-codes: C14 I14 I18 (search for similar items in EconPapers)
Date: 2016
New Economics Papers: this item is included in nep-hea
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Working Paper: 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 (2016)
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