{"id":1010,"date":"2014-12-02T20:22:23","date_gmt":"2014-12-02T19:22:23","guid":{"rendered":"https:\/\/blogs.bmj.com\/adc\/?p=1010"},"modified":"2014-11-28T15:00:27","modified_gmt":"2014-11-28T14:00:27","slug":"statsminiblog-surrogate-proxy-or-process","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/adc\/2014\/12\/02\/statsminiblog-surrogate-proxy-or-process\/","title":{"rendered":"StatsMiniBlog: Surrogate, proxy or process?"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/adc\/files\/2014\/02\/20140205-091454.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-859\" src=\"https:\/\/blogs.bmj.com\/adc\/files\/2014\/02\/20140205-091454.jpg\" alt=\"20140205-091454.jpg\" width=\"180\" height=\"76\" \/><\/a>When we look at treatments for children&#8217;s ill health, we tend to be stuck in a pleasant dilemma. We normally want to use treatments to stop kids dying, and to make them better quicker &#8211; but it&#8217;s uncommon for children to die, and they&#8217;ll often get better anyway. So we end up using alternative <a title=\"Many outcomes give no answer?\" href=\"https:\/\/blogs.bmj.com\/adc\/2010\/07\/14\/many-outcomes-give-no-answer\/\">outcome measures<\/a>; a proxy, surrogate or process measure. Do you know what the difference is?<\/p>\n<a name=\"pd_a_8458110\"><\/a>\n<div class=\"CSS_Poll PDS_Poll\" id=\"PDI_container8458110\" style=\"display:inline-block;\"><\/div>\n<div id=\"PD_superContainer\"><\/div>\n<script type=\"text\/javascript\" charset=\"UTF-8\" src=\"https:\/\/static.polldaddy.com\/p\/8458110.js\"><\/script>\n<noscript><a href=\"https:\/\/poll.fm\/8458110\">Take Our Poll<\/a><\/noscript>\n<p><!--more--><\/p>\n<p>A proxy outcome refers to something we measure in an attempt to get at an intangible &#8211; so quality of life measures attempt to capture the truth of how someone&#8217;s life is and affects them. You&#8217;re often in a state where there are a few ways of trying to understand the intangible, so you might find a number of different measures being used to triangulate onto the &#8216;truth&#8217; of the unmeasured.<\/p>\n<p>A surrogate measure is something which the study folk believe is intimately related to the outcome we really want to measure, because it&#8217;s too rare, or takes to long to occur. Some surrogates appear to be robust; looking at the amount of minimal residual disease in acute lymphoblastic leukaemia really really does relate to survival. Others aren&#8217;t as good though &#8211; examples might be bone mineral density in preventing fractures from osteoporosis (this was shown to be incorrect when fluoride was used &#8211; great at increasing BMD and even better at increasing fracture risk), or length of time on a ventilator and neurodevelopmental outcome after the neonatal period.<\/p>\n<p>A process measure is where we&#8217;re just seeing what&#8217;s been done, and this may, or may not, have any relationship with the outcome. Take duration of hospitalisation and &#8230; well &#8230; almost anything.<\/p>\n<p>It&#8217;s important to know what is being measured, what you want to really know (<a title=\"What would Jack want?\" href=\"https:\/\/blogs.bmj.com\/adc\/2010\/03\/10\/what-would-jack-want\/\">What would Jack want?<\/a>) and how those things are related. Understanding these things can get us closer to making clinical research applicable, meaningful and replicable.<\/p>\n<p>&#8211; Archi<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>When we look at treatments for children&#8217;s ill health, we tend to be stuck in a pleasant dilemma. We normally want to use treatments to stop kids dying, and to make them better quicker &#8211; but it&#8217;s uncommon for children to die, and they&#8217;ll often get better anyway. So we end up using alternative outcome [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/adc\/2014\/12\/02\/statsminiblog-surrogate-proxy-or-process\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2676],"tags":[],"class_list":["post-1010","post","type-post","status-publish","format-standard","hentry","category-stats"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>StatsMiniBlog: Surrogate, proxy or process? - ADC Online Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/adc\/2014\/12\/02\/statsminiblog-surrogate-proxy-or-process\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"StatsMiniBlog: Surrogate, proxy or process? - ADC Online Blog\" \/>\n<meta property=\"og:description\" content=\"When we look at treatments for children&#8217;s ill health, we tend to be stuck in a pleasant dilemma. We normally want to use treatments to stop kids dying, and to make them better quicker &#8211; but it&#8217;s uncommon for children to die, and they&#8217;ll often get better anyway. 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