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Comment & Response |

Lag Time to Benefit for Preventive Therapies—Reply

Sei J. Lee, MD, MAS1; Rosanne M. Leipzig, MD, PhD2; Louise C. Walter, MD1
[+] Author Affiliations
1Division of Geriatrics, University of California, San Francisco
2Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
JAMA. 2014;311(15):1567-1568. doi:10.1001/jama.2014.2325.
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In Reply Dr Braithwaite notes the similarities between our proposed concept of lag time to benefit and the concept of payoff time. We absolutely agree.

Both concepts recognize that for many interventions, the harms occur before the benefits. Thus, both concepts strive to determine which patients are most likely to benefit from the intervention by comparing a patient’s life expectancy with the intervention’s time to benefit. Although we presented the lag time to benefit as a fixed property of the intervention, the payoff time attempts to individualize the time to benefit by incorporating an individual patient’s risk factors, potentially leading to a more accurate, individualized estimate of the time to benefit.


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April 16, 2014
R. Scott Braithwaite, MD, MS
1Department of Population Health, NYU School of Medicine, New York, New York
JAMA. 2014;311(15):1566. doi:10.1001/jama.2014.2317.
April 16, 2014
Holly M. Holmes, MD; Lillian Min, MD, MSHS; Cynthia Boyd, MD, MPH
1University of Texas MD Anderson Cancer Center, Houston
2Division of Geriatric Medicine, University of Michigan, Ann Arbor
3Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, Maryland
JAMA. 2014;311(15):1567. doi:10.1001/jama.2014.2320.
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