Caveat medicus: it's time to re-think stratification, you may not be helping

Oggie Arandelovic

doi:10.1177/11772719231174746

Caveat medicus: it's time to re-think stratification, you may not be helping

Oggie Arandelovic^*

^*Corresponding author for this work

School of Computer Science

Research output: Contribution to journal › Article › peer-review

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Abstract

Background
The focus of the present Letter is on the large and seemingly fertile body of work captured under the umbrella of ‘patient stratification’.

Objectives
I identify and explain a fundamental methodological flaw underlying the manner in which the development of an increasingly large number of new stratification strategies is approached.

Design
I show an inherent conflict between the assumptions made, and the very purpose of stratification and its application in practice.

Methods
I analyse the methodological underpinnings of stratification as presently done and draw parallels with conceptually similarly flawed precedents which are now widely recognized.

Results
The highlighted flaw is shown to undermine the overarching ultimate goal of improved patient outcomes by undue fixation on an ill-founded proxy.

Conclusion
I issue a call for a re-think of the problem and the processes leading to the adoption of new stratification strategies in the clinic.

Original language	English
Number of pages	3
Journal	Biomarkers Insights
Volume	18
Early online date	14 May 2023
DOIs	https://doi.org/10.1177/11772719231174746
Publication status	Published - 1 Dec 2023

Keywords

Risk
Biomarkers
Personalized
Targeted
Precision

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10.1177/11772719231174746Licence: CC BY

Arandjelovic_2023_BI_Caveat-Medicus_CC
Copyright © The Author(s) 2023. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Final published version, 225 KBLicence: CC BY

Cite this

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title = "Caveat medicus: it's time to re-think stratification, you may not be helping",

abstract = "BackgroundThe focus of the present Letter is on the large and seemingly fertile body of work captured under the umbrella of {\textquoteleft}patient stratification{\textquoteright}.ObjectivesI identify and explain a fundamental methodological flaw underlying the manner in which the development of an increasingly large number of new stratification strategies is approached.DesignI show an inherent conflict between the assumptions made, and the very purpose of stratification and its application in practice.MethodsI analyse the methodological underpinnings of stratification as presently done and draw parallels with conceptually similarly flawed precedents which are now widely recognized.ResultsThe highlighted flaw is shown to undermine the overarching ultimate goal of improved patient outcomes by undue fixation on an ill-founded proxy.ConclusionI issue a call for a re-think of the problem and the processes leading to the adoption of new stratification strategies in the clinic.",

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N2 - BackgroundThe focus of the present Letter is on the large and seemingly fertile body of work captured under the umbrella of ‘patient stratification’.ObjectivesI identify and explain a fundamental methodological flaw underlying the manner in which the development of an increasingly large number of new stratification strategies is approached.DesignI show an inherent conflict between the assumptions made, and the very purpose of stratification and its application in practice.MethodsI analyse the methodological underpinnings of stratification as presently done and draw parallels with conceptually similarly flawed precedents which are now widely recognized.ResultsThe highlighted flaw is shown to undermine the overarching ultimate goal of improved patient outcomes by undue fixation on an ill-founded proxy.ConclusionI issue a call for a re-think of the problem and the processes leading to the adoption of new stratification strategies in the clinic.

AB - BackgroundThe focus of the present Letter is on the large and seemingly fertile body of work captured under the umbrella of ‘patient stratification’.ObjectivesI identify and explain a fundamental methodological flaw underlying the manner in which the development of an increasingly large number of new stratification strategies is approached.DesignI show an inherent conflict between the assumptions made, and the very purpose of stratification and its application in practice.MethodsI analyse the methodological underpinnings of stratification as presently done and draw parallels with conceptually similarly flawed precedents which are now widely recognized.ResultsThe highlighted flaw is shown to undermine the overarching ultimate goal of improved patient outcomes by undue fixation on an ill-founded proxy.ConclusionI issue a call for a re-think of the problem and the processes leading to the adoption of new stratification strategies in the clinic.

KW - Risk

KW - Biomarkers

KW - Personalized

KW - Targeted

KW - Precision

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DO - 10.1177/11772719231174746

M3 - Article

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VL - 18

JO - Biomarkers Insights

JF - Biomarkers Insights

ER -

Caveat medicus: it's time to re-think stratification, you may not be helping

Abstract

Keywords

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