{"title":"Caveat Medicus: It's Time to Re-Think Stratification, You May Not Be Helping.","authors":"Ognjen Arandjelović","doi":"10.1177/11772719231174746","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The focus of the present Letter is on the large and seemingly fertile body of work captured under the umbrella of 'patient stratification'.</p><p><strong>Objectives: </strong>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.</p><p><strong>Design: </strong>I show an inherent conflict between the assumptions made, and the very purpose of stratification and its application in practice.</p><p><strong>Methods: </strong>I analyse the methodological underpinnings of stratification as presently done and draw parallels with conceptually similarly flawed precedents which are now widely recognized.</p><p><strong>Results: </strong>The highlighted flaw is shown to undermine the overarching ultimate goal of improved patient outcomes by undue fixation on an ill-founded proxy.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":47060,"journal":{"name":"Biomarker Insights","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10186568/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Biomarker Insights","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/11772719231174746","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
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.