Lead-time bias versus Length-time bias
Posted by dkwinter

Figures are from-- and longer (but not necessarily clearer) explanations can be found here: http://ecp.acponline.org/marapr99/primer.htm

Lead-time bias: Overestimation of survival duration due to earlier detection by screening than clinical presentation.

Length-time bias: Overestimation of survival duration due to the relative excess of cases detected that are slowly progressing.

  • Imagine all 12 cases below are the same disease. Instead of being seen as rapidly progressive 50% of the time, rapidly progressive disease is only detected in 33% of positive screens.


Length-time bias is due to slow cases being detected more often simply because they are slowly progressing. Remember the "g" in length is for slowly progressing.

Lead-time bias is due to early detection. Remember the "d" in lead is for early detection.