{"about":{"site":"https://codewithpapers.app","non_affiliation":"Code with Papers and Syntology are not affiliated with, endorsed by, or sponsored by Papers with Code, Meta, or the pwc-archive mirror.","licence":"CC BY-SA 4.0","licence_url":"https://creativecommons.org/licenses/by-sa/4.0/legalcode","attribution":"https://codewithpapers.app/attribution","modified":"archive material modified by Syntology; see the attribution page"},"url":"/paper/a-simulation-and-case-study-to-evaluate-the","title":"A simulation and case study to evaluate the extrapolation performance of flexible Bayesian survival models when incorporating real-world data","arxiv_id":"2505.16835","date":"2025-05-22","proceeding":null,"authors":["Iain R. Timmins","Fatemeh Torabi","Christopher H. Jackson","Paul C. Lambert","Michael J. Sweeting"],"abstract":"Background: Assessment of long-term survival for health technology assessment often necessitates extrapolation beyond the duration of a clinical trial. Without robust methods and external data, extrapolations are unreliable. Flexible Bayesian survival models that incorporate longer-term data sources, including registry data and population mortality, have been proposed as an alternative to using standard parametric models with trial data alone. Methods: The accuracy and uncertainty of extrapolations from the survextrap Bayesian survival model and R package were evaluated. In case studies and simulations, we assessed the accuracy of estimates with and without long-term data, under different assumptions about the long-term hazard rate and how it differs between datasets, and about treatment effects. Results: The survextrap model gives accurate extrapolations of long-term survival when long-term data on the patients of interest are included. Even using moderately biased external data gives improvements over using the short-term trial data alone. Furthermore, the model gives accurate extrapolations of differences in survival between treatment groups, provided that a reasonably accurate assumption is made about how the treatment effect will change over time. If no long-term data are available, then the model can quantify structural uncertainty about potential future changes in hazard rates. Conclusions: This analysis shows that Bayesian modelling can give accurate and reliable survival extrapolations by making the most of all available trial and real-world data. This work improves confidence in the use of a powerful tool for evidence-based healthcare decision-making.","url_abs":"https://arxiv.org/abs/2505.16835v1","url_pdf":"https://arxiv.org/pdf/2505.16835v1.pdf","source":{"archive":"pwc-archive (Hugging Face), CC BY-SA 4.0","snapshot":"2025-07-28","licence_url":"https://creativecommons.org/licenses/by-sa/4.0/legalcode","row_kind":"links_only","authors_date_abstract":"arXiv metadata, CC0 1.0 (https://info.arxiv.org/help/license), from the Kaggle arXiv metadata snapshot of 2026-09-12"},"code_links":[{"paper_slug":"a-simulation-and-case-study-to-evaluate-the","repo_url":"https://github.com/irtimmins/simulation-study2-rwe-survextrap","is_official":1,"mentioned_in_paper":1,"mentioned_in_github":0,"framework":"none","reach":null}],"tasks":[],"methods":[],"datasets_introduced":[],"methods_introduced":[],"results":[],"syntology":{"atlas_url":null,"mcp":null,"developers":"https://syntology.ai/developers"},"arxiv_metadata":null,"syntology_extracted_results":null}