This function calculates the Net Health Benefit (NHB) based on the American Society of Clinical Oncology (ASCO) Value Framework. It differentiates between two clinical settings: "advanced" (metastatic) and "adjuvant" (curative intent), as their scoring criteria differ significantly.
Usage
calculate_asco_nhb(
setting,
os_hr = NA,
os_median_control = NA,
os_median_treatment = NA,
pfs_hr = NA,
pfs_median_control = NA,
pfs_median_treatment = NA,
orr_treatment = NA,
dfs_hr = NA,
total_tox_points_control = 0,
total_tox_points_treatment = 0,
bonus_tail_of_curve = FALSE,
bonus_qol = FALSE,
bonus_palliation = FALSE,
bonus_treatment_free_interval_points = 0
)Arguments
- setting
A string specifying the clinical context. Must be either "advanced" or "adjuvant".
- os_hr
Numeric. The Hazard Ratio for Overall Survival.
- os_median_control
Numeric. Median Overall Survival for the control arm (in months).
- os_median_treatment
Numeric. Median Overall Survival for the treatment arm (in months).
- pfs_hr
Numeric. The Hazard Ratio for Progression-Free Survival.
- pfs_median_control
Numeric. Median Progression-Free Survival for the control arm (in months).
- pfs_median_treatment
Numeric. Median Progression-Free Survival for the treatment arm (in months).
- orr_treatment
Numeric. The Objective Response Rate for the treatment arm (as a decimal, e.g., 0.40 for 40%).
- dfs_hr
Numeric. The Hazard Ratio for Disease-Free Survival (used in 'adjuvant' setting).
- total_tox_points_control
A numeric value for the sum of toxicity points for the control/standard-of-care arm.
- total_tox_points_treatment
A numeric value for the sum of toxicity points for the new/experimental arm.
- bonus_tail_of_curve
Logical (TRUE/FALSE). Was a significant long-term survival benefit ("tail of the curve") demonstrated?
- bonus_qol
Logical (TRUE/FALSE). Was a statistically significant improvement in Quality of Life reported?
- bonus_palliation
Logical (TRUE/FALSE). Was significant symptom palliation shown? (for 'advanced' setting).
- bonus_treatment_free_interval_points
Numeric. Points for treatment-free interval (for 'advanced' setting).
Value
A named list with four elements: clinical_benefit_score, toxicity_adjustment,
bonus_score, and net_health_benefit.
Examples
# Example 1: Advanced Disease (Metastatic)
# Hypothetical trial where the primary endpoint is OS improvement shown by HR.
calculate_asco_nhb(
setting = "advanced",
os_hr = 0.75,
total_tox_points_control = 50,
total_tox_points_treatment = 60,
bonus_qol = TRUE,
bonus_palliation = FALSE
)
#> $clinical_benefit_score
#> [1] 25
#>
#> $toxicity_adjustment
#> [1] -4
#>
#> $bonus_score
#> [1] 10
#>
#> $net_health_benefit
#> [1] 31
#>
# Example 2: Adjuvant Setting (Curative Intent)
# Based on the SPARTAN trial for apalutamide.
calculate_asco_nhb(
setting = "adjuvant",
os_hr = 0.78,
total_tox_points_control = 37.0,
total_tox_points_treatment = 43.7,
bonus_tail_of_curve = TRUE,
bonus_qol = FALSE
)
#> $clinical_benefit_score
#> [1] 22
#>
#> $toxicity_adjustment
#> [1] -3.62
#>
#> $bonus_score
#> [1] 20
#>
#> $net_health_benefit
#> [1] 38.38
#>