In randomized clinical trials, a pre-treatment measurement is often taken at baseline, and post-treatment effects are measured at several time points post-baseline, say t=1, ..., T. At the end of the trial, it is of interest to assess the treatment effect based on the mean change from baseline at the last time point T. We consider statistical methods for (i) a point estimate and 95 per cent confidence interval for the mean change from baseline at time T for each treatment group, and (ii) a p-value and 95 per cent confidence interval for the between-group difference in the mean change from baseline. The manner in which the baseline responses are used in the analysis influences both the accuracy and the efficiency of items (i) and (ii). In this paper, we will consider the ANCOVA approach with change from baseline as a dependent variable and compare that with a constrained longitudinal data analysis (cLDA) model proposed by Liang and Zeger (Sankhya: Indian J. Stat. (Ser B) 2000; 62:134-148), in which the baseline is modeled as a dependent variable in conjunction with the constraint of a common baseline mean across the treatment groups. Some drawbacks of the ANCOVA model and potential advantages of the cLDA approach are discussed and illustrated using numerical simulations.
In clinical trials, missing data commonly arise through nonadherence to the randomized treatment or to study procedure. For trials in which recurrent event endpoints are of interests, conventional analyses using the proportional intensity model or the count model assume that the data are missing at random, which cannot be tested using the observed data alone. Thus, sensitivity analyses are recommended. We implement the control-based multiple imputation as sensitivity analyses for the recurrent event data. We model the recurrent event using a piecewise exponential proportional intensity model with frailty and sample the parameters from the posterior distribution. We impute the number of events after dropped out and correct the variance estimation using a bootstrap procedure. We apply the method to an application of sitagliptin study.
Developing sophisticated statistical methods for go/no-go decisions is crucial for clinical trials, as planning phase III or phase IV trials is costly and time consuming. In this paper, we develop a novel Bayesian methodology for determining the probability of success of a treatment regimen on the basis of the current data of a given trial. We introduce a new criterion for calculating the probability of success that allows for inclusion of covariates as well as allowing for historical data based on the treatment regimen, and patient characteristics. A new class of prior distributions and covariate distributions is developed to achieve this goal. The methodology is quite general and can be used with univariate or multivariate continuous or discrete data, and it generalizes ChuangStein's work. This methodology will be invaluable for informing the scientist on the likelihood of success of the compound, while including the information of covariates for patient characteristics in the trial population for planning future pre-market or post-market trials.
It is an important and yet challenging task to identify true signals from many adverse events that may be reported during the course of a clinical trial. One unique feature of drug safety data from clinical trials, unlike data from post-marketing spontaneous reporting, is that many types of adverse events are reported by only very few patients leading to rare events. Due to the limited study size, the -values of testing whether the rate is higher in the treatment group across all types of adverse events are in general not uniformly distributed under the null hypothesis that there is no difference between the treatment group and the placebo group. A consequence is that typically fewer than 100 percent of the hypotheses are rejected under the null at the nominal significance level of . The other challenge is multiplicity control. Adverse events from the same body system may be correlated. There may also be correlations between adverse events from different body systems. To tackle these challenging issues, we develop Monte-Carlo-based methods for the signal identification from patientreported adverse events in clinical trials. The proposed methodologies account for the rare events and arbitrary correlation structures among adverse events within and/or between body systems. Extensive simulation studies demonstrate that the proposed method can accurately control the family-wise error rate and is more powerful than existing methods under many practical situations. Application to two real examples is provided.
KEYWORDSfamily-wise error rate, multiplier bootstrap, permutation test, rademacher sequence, score test 1 Biometrics. 2019;1-9 wileyonlinelibrary.com/journal/biom
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