Simulated Treatment Comparison (STC)
Simulated Treatment Comparison (STC) is a statistical method used in health technology assessment to compare treatments when direct head-to-head trials are not available. It uses individual patient data to adjust for differences in patient populations across studies and predicts how one treatment would perform in the population of another trial.
At a glance
Use when
Comparing treatments without direct randomized comparisons; when individual patient data is available from one or more trials; when population differences between trials may bias results
Avoid when
IPD is unavailable or of poor quality; when the outcome model cannot be reliably estimated; when there are substantial differences in trial design or outcome definitions
Inputs
Individual patient data (IPD) from one or more trials, aggregate data from comparator trials, covariates for adjustment
Outputs
Adjusted treatment effect estimates, predicted outcomes in the target population, indirect comparison results
How it works
STC is a population-adjusted indirect comparison method that involves fitting an outcome regression model on individual patient data (IPD) from one trial and using it to predict outcomes in the population of a different trial. It serves as a regression-based alternative to Matching-Adjusted Indirect Comparison (MAIC), as described in NICE Decision Support Unit Technical Support Document 18 (NICE DSU TSD18).
- HTA domains
- Clinical Effectiveness, Costs & Economic Evaluation
- Categories
- Indirect Comparisons
- Assumptions
- The outcome regression model is correctly specified; the relationship between covariates and outcomes is consistent across trials; availability of sufficient individual patient data
- Strengths
- Allows for more flexible adjustment using regression; can handle continuous and categorical covariates; uses all available IPD; may improve precision over other indirect comparison methods
- Limitations
- Relies heavily on correct model specification; requires access to individual patient data which may not be available; potential bias if key covariates are missing or interactions are unaccounted for
- Also known as
- STC
Questions this answers
- › How does a treatment perform compared to another when no direct trial exists?
- › What would the outcomes be if patients from one trial received a different treatment?
- › How can we adjust for differences in patient characteristics across trials?
- › Can we use individual patient data to improve indirect comparisons?
- › How does STC differ from other indirect comparison methods like MAIC?
- › Is the treatment effect robust after adjusting for population differences?
References & sources
Similar by meaning
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