Using Regression Discontinuity in Time to Strengthen Real-World Evidence: A Case Study in Lung Cancer

Using a real-world cohort of 1,975 patients with advanced non-small-cell lung cancer, the authors applied regression discontinuity in time (RDiT) to estimate the comparative effectiveness of pembrolizumab versus docetaxel while addressing unmeasured confounding from historical controls. RDiT produced survival estimates more closely aligned with long-term clinical trial data than traditional propensity score methods, suggesting it may be a valuable tool for generating credible real-world evidence to inform regulatory, coverage, and drug pricing decisions.