Please cite this article as: Matter-Walstra K, Schwenkglenks M, Aebi S, Dedes K, Diebold J, Pietrini M, Klingbiel D, von Moos R, Gautschi O, for the SAKK, A cost-effectiveness analysis of nivolumab versus docetaxel for advanced non-squamous non-small cell lung cancer including PDAbstract Background: Nivolumab (NIV) was recently approved in several countries for patients with pre-

Introduction Readmissions after an acute care hospitalization are relatively common, costly to the health care system, and are associated with significant burden for patients. As one way to reduce costs and simultaneously improve quality of care, hospital readmissions receive increasing interest from policy makers. It is only relatively recently that strategies were developed with the specific aim of reducing unplanned readmissions using prediction models to identify patients at risk. EPIC’s Risk of Unplanned Readmission model promises superior performance. However, it has only been validated for the US setting. Therefore, the main objective of this study is to externally validate the EPIC’s Risk of Unplanned Readmission model and to compare it to the internationally, widely used LACE+ index, and the SQLAPE® tool, a Swiss national quality of care indicator. Methods A monocentric, retrospective, diagnostic cohort study was conducted. The study included inpatients, who were discharged between the 1st of January 2018 and the 31st of December 2019 from the Lucerne Cantonal Hospital, a tertiary-care provider in Central Switzerland. The study endpoint was an unplanned 30-day readmission. Models were replicated using the original intercept and beta coefficients as reported. Otherwise, score generator provided by the developers were used. For external validation, discrimination of the scores under investigation were assessed by calculating the area under the receiver operating characteristics curves (AUC). Calibration was assessed with the Hosmer-Lemeshow X2 goodness-of-fit test This report adheres to the TRIPOD statement for reporting of prediction models. Results At least 23,116 records were included. For discrimination, the EPIC´s prediction model, the LACE+ index and the SQLape® had AUCs of 0.692 (95% CI 0.676–0.708), 0.703 (95% CI 0.687–0.719) and 0.705 (95% CI 0.690–0.720). The Hosmer-Lemeshow X2 tests had values of p<0.001. Conclusion In summary, the EPIC´s model showed less favorable performance than its comparators. It may be assumed with caution that the EPIC´s model complexity has hampered its wide generalizability—model updating is warranted.

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two-step process. The first step was for subject matter based on keywords: NSCLC, SCLC or immunotherapy. Searches differed slightly based on individual website functionality, with ASCO searched by track, World Lung by session and ESMO by individual abstract. In a second step, abstracts for which clinical outcome data was presented from a trial with an identifiable NCT number were selected. Immunotherapy abstracts that did not include the treatment of NSCLC or SCLC were excluded in the second step. Results: 851 abstracts were identified that were related to NSCLC, SCLC or immunotherapy. Of these, 357 referred to a clinical trial. 110 of 357 (30%) described clinical trials that were presented multiple times (mean 2.75, range 2-7), and in 44 (12%), this occurred at the same conference. 113 of 357 abstracts (31%) were oral presentations. 75 (66%) of the oral presentations presented data from clinical trials that were presented multiple times, including 35 (31%) which were presented as oral presentations at least twice. Of the 16 unique clinical trials leading to multiple oral presentations, a variety of issues led to the duplicate presentations, including different cohorts of the same trial, biomarker analysis, analysis by one study variable, or simply updated data. In total, only 6 of 16 of these studies presented additional patients in a subsequent oral presentation, two presenting unique cohorts, and the other four presenting updated data that included additional patients, in one case, fewer than ten patients. Conclusion: There is a pattern of multiple presentations of clinical trials, particularly in oral presentations, at major meetings. Although a second oral presentation on the same concept may sound confirmatory to a conference participant, in most cases, data presented in subsequent oral presentations related entirely to patients whose data was presented in the previous oral presentation.