The Adenomatous Polyp Prevention on Vioxx (APPROVe) trial1 comparedrofecoxib with placebo in the prevention of recurrent colorectalpolyps, but the researchers also collected data on adverse cardiovascularevents, including confirmed serious thrombotic events. Assessmentof the cardiovascular data raises important issues about theanalysis and interpretation of a time-to-event end point ina randomized, placebo-controlled trial evaluating a long-termtreatment. These issues include the appropriate period of follow-upfor safety outcomes after the discontinuation of treatment;the purpose and implications of checking the assumption of proportionalhazards, which underlies the commonly used log-rank test andCox model; and what . . . [Full Text of this Article]
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Dr. Lagakos is a professor of biostatistics at the Harvard School of Public Health, Boston, and a statistical consultant to the Journal.
This article was published at www.nejm.org on June 26, 2006.
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