Re: Nabhan C, Phillips EG Jr, Feinberg BA. Value in Oncology: It Is in the Eyes of the Beholder. J Natl Compr Canc Netw 2019;17(1):2–5.
In their JNCCN commentary, “Value in Oncology: It Is in the Eyes of the Beholder,” Nabhan et al1 cite an editorial that claimed the ASCO Value Framework and ESMO Magnitude of Clinical Benefit Scale (MCBS) were widely discordant and could not agree as to what constitutes a high or low level of benefit.2
In a recently published collaborative project, the developers of the ASCO Value Framework and the ESMO-MCBS compared the results of scores generated for 102 comparative studies.3
This comparative analysis, performed by experts in the use of these scoring systems, demonstrated substantial correlation (Spearman correlation, 0.68) between the scales and highlighted the methodologic issues driving disparity that can be addressed to further improve concordance.3
The current versions of the ASCO and ESMO value scales, when expertly applied, do have substantial but, as yet, imperfect agreement. Both ESMO and ASCO are committed to rigorous processes of validation in the ongoing development of their respective frameworks, and users can expect improvements as the scales are further refined.
Finally, we believe that these scales can make a substantial contribution to the public health discourse, rational patient care, research design, and physician education.
CALL FOR CORRESPONDENCE
JNCCN is committed to providing a forum to enhance collaboration between academic medicine and the community physician. We welcome comments about the NCCN Guidelines, articles published in the journal, or any other topic relating to cancer prevention, detection, treatment, supportive care, or survivorship. Please submit correspondence to www.editorialmanager.com/JNCCN.
Letters should be no more than 400 words, with no more than 5 references if included. NCCN reserves the right not to publish correspondence for any reason it deems appropriate. All letters are subject to editing and/or abridgment.
Nabhan C, Phillips EG Jr, Feinberg BA. Value in oncology: it is in the eyes of the beholder. J Natl Compr Canc Netw 2019;17:2–5.
Evans WK, Cheung MC, Chan KK. Measuring value and benefit: a matter of perspective. Lancet Oncol 2017;18:839–840.
Cherny NI, de Vries EG, Dafni U, et al.. Comparative assessment of clinical benefit using the ESMO-Magnitude of Clinical Benefit Scale version 1.1 and the ASCO Value Framework Net Health Benefit Score. J Clin Oncol 2018;37:336–349.