The impact of a psychosocial support program on survival with breast cancer: the importance of selection bias in program evaluation

J Chronic Dis. 1984;37(4):273-82. doi: 10.1016/0021-9681(84)90135-8.

Abstract

A retrospective follow-up study was conducted to assess the impact of a psychosocial support program on survival with breast cancer. One-hundred and two nonparticipants were individually matched to 34 participants on several prognostic factors, and both groups were followed from date of cancer diagnosis (1971-1980) until December, 1981. Preliminary findings suggest a strong beneficial effect of the program on survival, which is statistically significant. However, this observed effect is due largely to a selection bias caused by the failure to match on the duration of the lag period between cancer diagnosis and program entry. Correcting for this bias in the analysis results in a small, nonsignificant program effect. We are not able to rule out a possible effect, however, because of the relative lack of statistical power and because of a modest, though nonsignificant benefit observed for women who entered the program shortly after diagnosis. Furthermore, the program might have other beneficial effects on the quality of life.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / mortality
  • Breast Neoplasms / psychology*
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Middle Aged
  • Prognosis
  • Quality of Life
  • Retrospective Studies
  • Self-Help Groups*
  • Social Environment*
  • Social Support*