Summary: | We would like to comment on the manuscript written by Esserman and colleagues [1] regarding the application of a decision analytic framework for adoption of clinical trial results. It is true that due to the prevalence of breast cancer, any management decision concerning its treatment may have significant implications concerning medical resources use and costs. However, this also holds true for any mistake or hasty decision that might carry a heavy price on public health in the long term. If the purpose of the model presented in the article aimed to describe an analytic framework, then for the purpose of proof of concept, the statistical analysis should be applied first on treatments for which long-term follow-up is available, in order to prove and validate that the model can predict the same results as in the reality of daily practice. The use of the currently available TARGIT-A trial data to evaluate this model is inappropriate since follow-up in the TARGIT-A trial is immature [2, 3]
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