One‐sided Simultaneous Confidence Intervals for Effective Dose Steps in Unbalanced Designs

An important issue in dose finding is whether a further dose increment leads to a relevant increase in efficacy. Clinical efficacy should not be considered by point zero null hypotheses. Instead, shifted hypotheses for the difference or the ratio can be used. Because the a priori definition of a relevance threshold is frequently difficult, confidence intervals should be used for a posteriori interpretation. Sample size estimation – a‐priori or by adaptive interim analysis‐ is inherent, because the effective dose steps are arbitrary in un‐designed studies. For simultaneous confidence intervals without order restriction the exact distributions under the null and the alternative hypothesis is proposed for the general unbalanced one‐way design.     

Obtaining Critical Values for Simultaneous Confidence Intervals and Multiple Testing

There are many situations where it is desired to make simultaneous tests or give simultaneous confidence intervals for linear combinations (contrasts) of population or treatment means. Somerville (1997, 1999) developed algorithms for calculating the critical values for a large class of simultaneous tests and simultaneous confidence intervals. Fortran 90 and SAS‐IML batch programs and interactive programs were developed. These programs calculate the critical values for 15 different simultaneous confidence interval procedures (and the corresponding simultaneous tests) and for arbitrary procedures where the user specifies a combination of one and two sided contrasts. The programs can also be used to obtain the constants for “step‐down” testing of multiple hypotheses. This paper gives examples of the use of the algorithms and programs and illustrates their versatility and generality. The designs need not be balanced, multiple covariates may be present and there may be many missing values. The use of multiple regression and dummy variables to obtain the required variance covariance matrix is illustrated. Under weak normality assumptions the methods are “exact” and make the use of approximate methods or “simulation” unnecessary.     

Alternative Confidence Regions for Bonferroni‐Based Closed‐Testing Procedures that are not Alpha‐Exhaustive

This article complements the results in Guilbaud (Biometrical Journal 2008; 50 :678–692). Simultaneous confidence regions were derived in that article that correspond to any given multiple testing procedure (MTP) in a fairly large class of consonant closed‐testing procedures based on marginal p‐values and weighted Bonferroni tests for intersection hypotheses. This class includes Holm's MTP, the fixed‐sequence MTP, gatekeeping MTPs, fallback MTPs, multi‐stage fallback MTPs, and recently proposed MTPs specified through a graphical representation and associated rejection algorithm. More general confidence regions are proposed in this article. These regions are such that for certain underlying MTPs which are not alpha‐exhaustive, they lead to confidence assertions that may be sharper than rejection assertions for some rejected null hypotheses H when not all Hs are rejected, which is not the case with the previously proposed regions. In fact, various alternative confidence regions may be available for such an underlying MTP. These results are shown through an extension of the previous direct arguments (without invoking the partitioning principle), and under the same general setup; so for instance, estimated quantities and marginal confidence regions are not restricted to be of any particular kinds/dimensions. The relation with corresponding confidence regions of Strassburger and Bretz (Statistics in Medicine 2008; 27 :4914–4927) is described. The results are illustrated with fallback and parallel‐gatekeeping MTPs.     

Applications and Tabulations of the Multivariate t Distribution with ρ = 0

Quantiles of the multivariate t distribution with ρ = 0 are tabulated. Some applications are discussed.     

Multiple Comparisons of Treatments with Stable Multivariate Tests in a Two‐Stage Adaptive Design,Including a Test for Non‐Inferiority

The application of stabilized multivariate tests is demonstrated in the analysis of a two‐stage adaptive clinical trial with three treatment arms. Due to the clinical problem, the multiple comparisons include tests of superiority as well as a test for non‐inferiority, where non‐inferiority is (because of missing absolute tolerance limits) expressed as linear contrast of the three treatments. Special emphasis is paid to the combination of the three sources of multiplicity – multiple endpoints, multiple treatments, and two stages of the adaptive design. Particularly, the adaptation after the first stage comprises a change of the a‐priori order of hypotheses.     

A Survey of Sample Size Formulas for Pairwise and Many‐one Multiple Comparisons in the Parametric,Nonparametric and Binomial Case

We present a survey of sample size formulas derived in other papers for pairwise comparisons of k treatments and for comparisons of k treatments with a control. We consider the calculation of sample sizes with preassigned per‐pair, any‐pair and all‐pairs power for tests that control either the comparisonwise or the experimentwise type I error rate. A comparison exhibits interesting similarities between the parametric, nonparametric and binomial case.     

Comparison of normal distribution–based and nonparametric decision limits on the GH‐2000 score for detecting growth hormone misuse (doping) in sport

This paper is motivated by the GH‐2000 biomarker test, though the discussion is applicable to other diagnostic tests. The GH‐2000 biomarker test has been developed as a powerful technique to detect growth hormone misuse by athletes, based on the GH‐2000 score. Decision limits on the GH‐2000 score have been developed and incorporated into the guidelines of the World Anti‐Doping Agency (WADA). These decision limits are constructed, however, under the assumption that the GH‐2000 score follows a normal distribution. As it is difficult to affirm the normality of a distribution based on a finite sample, nonparametric decision limits, readily available in the statistical literature, are viable alternatives. In this paper, we compare the normal distribution–based and nonparametric decision limits. We show that the decision limit based on the normal distribution may deviate significantly from the nominal confidence level or nominal FPR when the distribution of the GH‐2000 score departs only slightly from the normal distribution. While a nonparametric decision limit does not assume any specific distribution of the GH‐2000 score and always guarantees the nominal confidence level and FPR, it requires a much larger sample size than the normal distribution–based decision limit. Due to the stringent FPR of the GH‐2000 biomarker test used by WADA, the sample sizes currently available are much too small, and it will take many years of testing to have the minimum sample size required, in order to use the nonparametric decision limits. Large sample theory about the normal distribution–based and nonparametric decision limits is also developed in this paper to help understanding their behaviours when the sample size is large.