Re: The estimands framework: a primer on the ICH E9(R1) addendum

Agreement: 
I Agree
Body: 

Dear Editor,

I appreciate this primer on the ICH E9(R1) addendum. The authors write, “In time to-event settings, truncating events that prevent the outcome of interest from occurring are often referred to as competing events” and, “Because the treatment policy strategy requires outcome data after the intercurrent event, it cannot be used for truncating events”.

The combination of these two statements can give the impression that a treatment policy strategy cannot be used in the presence of competing events. This seems to be at odds at with the framework provided by Young et al. 2020: “We clarified that a competing event generally acts as a mediator of the treatment effect on the event of interest, leading to uncertain interpretation of the total effect.”

Can the authors please comment on this matter?

Reference:
Young JG, Stensrud MJ, Tchetgen Tchetgen EJ, Hernán MA. A causal framework for classical statistical estimands in failure-time settings with competing events. Stat Med. 2020 Apr 15;39(8):1199-1236. doi: 10.1002/sim.8471. Epub 2020 Jan 27. PMID: 31985089; PMCID: PMC7811594.

No competing Interests: 
Yes
The following competing Interests: 
Electronic Publication Date: 
Thursday, January 25, 2024 – 08:49
Workflow State: 
Released
Full Title: 

Re: The estimands framework: a primer on the ICH E9(R1) addendum

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Last Name: 
Blond
First name and middle initial: 
Kim
Address: 
Copenhagen, Denmark
Occupation: 
Health Technology Assessment
Affiliation: 
Danish Medicines Council
BMJ: Additional Article Info: 
Rapid response

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