16 ordspråk av Donald Berry

Donald Berry

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We need to rethink how we design and conduct clinical trials in the United States. Our current system has served us well for the past 50 years, but the demands of 21st century medicine are beginning to put a strain on the current system, and we believe we have something to relieve that strain.

Some people think the benefit of screening is huge, and others say that the reduction in death rates is due primarily to adjuvant therapy, ... No one has known for sure, and although we still don't know for sure, this is the best set of analyses that is possible given the available information.

Some people think the benefit of screening is huge, and others say that the reduction in death rates is due primarily to adjuvant therapy. No one has known for sure, and although we still don't know for sure, this is the best set of analyses that is possible given the available information.

Using the Bayesian approach, it is natural to do continuous updating as information accrues. This characteristic makes it possible for us to build adaptive designs in clinical trials.

Doctors want to be able to design trials to look at multiple potential treatment combinations and use biomarkers to determine who is responding to what medication. At the end of the day, when they enroll the last patient in the study they want to be able to treat that patient optimally depending on the patient's disease characteristics. Using a Bayesian approach, the trial design exploits the results as the trial is ongoing and adapts based on these interim results. That kind of thing is an anathema in the standard approach.

Our biggest challenge is to convince the regulators that we are not throwing the baby out with the bathwater by using a Bayesian approach. It is rigorous and we are not losing science by using it.

[The models may] help determine what strategies for delivering medical care are best for patients, ... and that is necessary, since our efforts, taken as a whole, haven't come close to eliminating breast cancer mortality.

The American Cancer Society has it right. I do think mammograms save lives.

Although less certain, screening indeed appears to be effective at lowering mortality.

This is the first time that a study does it right in asking the effects of screening separate from therapy.

This does solidify in my mind the case for screening,

The average woman can gain some comfort knowing that both these things that are going on are important.

We don't know the answers for sure. There's still some uncertainty because we don't have perfect data.

I'd do it again if I had to. We made it here all safely. That's the main thing. (Claudia and Joe) have been a blessing. I just wished they had lived a little bit closer.

All seven groups concluded that the decline in the rate of death from breast cancer is a combination of screening and therapy, and not restricted to one or the other.

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