共查询到20条相似文献，搜索用时 15 毫秒
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Dmitrienko A Tamhane AC Wang X Chen X 《Biometrical journal. Biometrische Zeitschrift》2006,48(6):984-991
This paper discusses multiple testing problems in which families of null hypotheses are tested in a sequential manner and each family serves as a gatekeeper for the subsequent families. Gatekeeping testing strategies of this type arise frequently in clinical trials with multiple objectives, e.g., multiple endpoints and/or multiple dose-control comparisons. It is demonstrated in this paper that the parallel gatekeeping procedure of Dmitrienko, Offen and Westfall (2003) admits a simple stepwise representation (n null hypotheses can be tested in n steps rather than 2n steps required in the closed procedure). The stepwise representation considerably simplifies the implementation of gatekeeping procedures in practice and provides an important insight into the nature of gatekeeping inferences. The derived stepwise gatekeeping procedure is illustrated using clinical trial examples. 相似文献
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The three‐arm design with a test treatment, an active control and a placebo group is the gold standard design for non‐inferiority trials if it is ethically justifiable to expose patients to placebo. In this paper, we first use the closed testing principle to establish the hierarchical testing procedure for the multiple comparisons involved in the three‐arm design. For the effect preservation test we derive the explicit formula for the optimal allocation ratios. We propose a group sequential type design, which naturally accommodates the hierarchical testing procedure. Under this proposed design, Monte Carlo simulations are conducted to evaluate the performance of the sequential effect preservation test when the variance of the test statistic is estimated based on the restricted maximum likelihood estimators of the response rates under the null hypothesis. When there are uncertainties for the placebo response rate, the proposed design demonstrates better operating characteristics than the fixed sample design. 相似文献
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Röhmel J Gerlinger C Benda N Läuter J 《Biometrical journal. Biometrische Zeitschrift》2006,48(6):916-933
In a clinical trial with an active treatment and a placebo the situation may occur that two (or even more) primary endpoints may be necessary to describe the active treatment's benefit. The focus of our interest is a more specific situation with two primary endpoints in which superiority in one of them would suffice given that non-inferiority is observed in the other. Several proposals exist in the literature for dealing with this or similar problems, but prove insufficient or inadequate at a closer look (e.g. Bloch et al. (2001, 2006) or Tamhane and Logan (2002, 2004)). For example, we were unable to find a good reason why a bootstrap p-value for superiority should depend on the initially selected non-inferiority margins or on the initially selected type I error alpha. We propose a hierarchical three step procedure, where non-inferiority in both variables must be proven in the first step, superiority has to be shown by a bivariate test (e.g. Holm (1979), O'Brien (1984), Hochberg (1988), a bootstrap (Wang (1998)), or L?uter (1996)) in the second step, and then superiority in at least one variable has to be verified in the third step by a corresponding univariate test. All statistical tests are performed at the same one-sided significance level alpha. From the above mentioned bivariate superiority tests we preferred L?uter's SS test and the Holm procedure for the reason that these have been proven to control the type I error strictly, irrespective of the correlation structure among the primary variables and the sample size applied. A simulation study reveals that the performance regarding power of the bivariate test depends to a considerable degree on the correlation and on the magnitude of the expected effects of the two primary endpoints. Therefore, the recommendation of which test to choose depends on knowledge of the possible correlation between the two primary endpoints. In general, L?uter's SS procedure in step 2 shows the best overall properties, whereas Holm's procedure shows an advantage if both a positive correlation between the two variables and a considerable difference between their standardized effect sizes can be expected. 相似文献
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Vance W. Berger YanYan Zhou Anastasia Ivanova Lothar Tremmel 《Biometrical journal. Biometrische Zeitschrift》2004,46(1):48-55
In the context of randomized clinical trials, multiplicity arises in many forms. One prominent example is when a key endpoint is measured and analyzed both at baseline and after treatment. It is common to analyze each separately, but more efficient to adjust the post‐treatment comparisons for the baseline values. Adjustment techniques generally treat the covariate (baseline value, in this case) as either nominal or continuous. Either is problematic when applied to an ordinal covariate, the former because it fails to exploit the natural ordering and the latter because it relies on an artifical notion of linear prediction and differences between values. We propose new methods for adjusting for ordinal covariates without having to treat them as nominal or continuous. Specifically, the information‐preserving composite endpoint consists of the pair of values for each patient, one at baseline and one after treatment. Some of these patterns will indicate more improvement than others, yet some pairs of patterns are not comparable. Hence, the ordering is only partial. We develop an approach to testing and deriving estimators of magnitudes of the treatment effect based on comparing each observation in one group to each observation in the other group to which it is comparable. (© 2004 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim) 相似文献
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The derivation of compatible confidence bounds related to stepwise decision procedures is a serious issue. Especially the derivation of step-up related bounds is rather complex. In this article we consider (one-sided) multiple comparisons with a control (MCC) and multiple comparisons with the best (MCB) with the aim of establishing delta-equivalence to the best and derive step-up related confidence bounds by applying the projection method proposed in Finner and Strassburger (2006). Some examples illustrate the resulting procedures. 相似文献
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Summary Phase II trials in oncology are usually conducted as single-arm two-stage designs with binary endpoints. Currently available adaptive design methods are tailored to comparative studies with continuous test statistics. Direct transfer of these methods to discrete test statistics results in conservative procedures and, therefore, in a loss in power. We propose a method based on the conditional error function principle that directly accounts for the discreteness of the outcome. It is shown how application of the method can be used to construct new phase II designs that are more efficient as compared to currently applied designs and that allow flexible mid-course design modifications. The proposed method is illustrated with a variety of frequently used phase II designs. 相似文献
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We consider the problem of drawing superiority inferences on individual endpoints following non-inferiority testing. R?hmel et al. (2006) pointed out this as an important problem which had not been addressed by the previous procedures that only tested for global superiority. R?hmel et al. objected to incorporating the non-inferiority tests in the assessment of the global superiority test by exploiting the relationship between the two, since the results of the latter test then depend on the non-inferiority margins specified for the former test. We argue that this is justified, besides the fact that it enhances the power of the global superiority test. We provide a closed testing formulation which generalizes the three-step procedure proposed by R?hmel et al. for two endpoints. For the global superiority test, R?hmel et al. suggest using the L?uter (1996) test which is modified to make it monotone. The resulting test not only is complicated to use, but the modification does not readily extend to more than two endpoints, and it is less powerful in general than several of its competitors. This is verified in a simulation study. Instead, we suggest applying the one-sided likelihood ratio test used by Perlman and Wu (2004) or the union-intersection t(max) test used by Tamhane and Logan (2004). 相似文献
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A multiple parametric test procedure is proposed, which considers tests of means of several variables. The single variables or subsets of variables are ordered according to a data‐dependent criterion and tested in this succession without alpha‐adjustment until the first non‐significant test. The test procedure needs the assumption of a multivariate normal distribution and utilizes the theory of spherical distributions. The basic version is particularly suited for variables with approximately equal variances. As a typical example, the procedure is applied to gene expression data from a commercial array. 相似文献
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In oncology, single‐arm two‐stage designs with binary endpoint are widely applied in phase II for the development of cytotoxic cancer therapies. Simon's optimal design with prefixed sample sizes in both stages minimizes the expected sample size under the null hypothesis and is one of the most popular designs. The search algorithms that are currently used to identify phase II designs showing prespecified characteristics are computationally intensive. For this reason, most authors impose restrictions on their search procedure. However, it remains unclear to what extent this approach influences the optimality of the resulting designs. This article describes an extension to fixed sample size phase II designs by allowing the sample size of stage two to depend on the number of responses observed in the first stage. Furthermore, we present a more efficient numerical algorithm that allows for an exhaustive search of designs. Comparisons between designs presented in the literature and the proposed optimal adaptive designs show that while the improvements are generally moderate, notable reductions in the average sample size can be achieved for specific parameter constellations when applying the new method and search strategy. 相似文献
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Jihnhee Yu James L. Kepner Renuka Iyer 《Biometrical journal. Biometrische Zeitschrift》2009,51(6):899-914
New therapy strategies for the treatment of cancer are rapidly emerging because of recent technology advances in genetics and molecular biology. Although newer targeted therapies can improve survival without measurable changes in tumor size, clinical trial conduct has remained nearly unchanged. When potentially efficacious therapies are tested, current clinical trial design and analysis methods may not be suitable for detecting therapeutic effects. We propose an exact method with respect to testing cytostatic cancer treatment using correlated bivariate binomial random variables to simultaneously assess two primary outcomes. The method is easy to implement. It does not increase the sample size over that of the univariate exact test and in most cases reduces the sample size required. Sample size calculations are provided for selected designs. 相似文献
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In the analysis of gene expression by microarrays there are usually few subjects, but high-dimensional data. By means of techniques, such as the theory of spherical tests or with suitable permutation tests, it is possible to sort the endpoints or to give weights to them according to specific criteria determined by the data while controlling the multiple type I error rate. The procedures developed so far are based on a sequential analysis of weighted p-values (corresponding to the endpoints), including the most extreme situation of weighting leading to a complete order of p-values. When the data for the endpoints have approximately equal variances, these procedures show good power properties. In this paper, we consider an alternative procedure, which is based on completely sorting the endpoints, but smoothed in the sense that some perturbations in the sequence of the p-values are allowed. The procedure is relatively easy to perform, but has high power under the same restrictions as for the weight-based procedures. 相似文献
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Given a k‐dimensional vector X , k≥2, the range‐type statistic with J⊆I≡{1, …, k}, plays an important role in stepwise subset selection as well as in testing whether a<?tlb> prespecified subset of k populations exclusively consists of good ones. Although in previous papers least favorable parameter configurations (LFC's) for this statistic, which are worth knowing for the calculations of critical values, have been already shown to be from a small finite subset of the parameter space, further reduction has been conjectured. Under the assumption of a log‐concave and symmetric Lebesgue density with shift parameter, it is proved that in many cases the LFC can be uniquely given or, at least, found among only a few candidates. The resulting step‐down selection procedure will be illustrated for data from a balanced incomplete block design. 相似文献
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Friede T Mitchell C Müller-Velten G 《Biometrical journal. Biometrische Zeitschrift》2007,49(6):903-916
Sample size calculations in the planning of clinical trials depend on good estimates of the model parameters involved. When the estimates of these parameters have a high degree of uncertainty attached to them, it is advantageous to reestimate the sample size after an internal pilot study. For non-inferiority trials with binary outcome we compare the performance of Type I error rate and power between fixed-size designs and designs with sample size reestimation. The latter design shows itself to be effective in correcting sample size and power of the tests when misspecification of nuisance parameters occurs with the former design. 相似文献
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Scott Brian Saxman 《Bioethics》2015,29(2):59-65
In a typical comparative clinical trial the randomization scheme is fixed at the beginning of the study, and maintained throughout the course of the trial. A number of researchers have championed a randomized trial design referred to as ‘outcome‐adaptive randomization.’ In this type of trial, the likelihood of a patient being enrolled to a particular arm of the study increases or decreases as preliminary information becomes available suggesting that treatment may be superior or inferior. While the design merits of outcome‐adaptive trials have been debated, little attention has been paid to significant ethical concerns that arise in the conduct of such studies. These include loss of equipoise, lack of processes for adequate informed consent, and inequalities inherent in the research design which could lead to perceptions of injustice that may have negative implications for patients and the research enterprise. This article examines the ethical difficulties inherent in outcome‐adaptive trials. 相似文献
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Samuel T. Hsiao Lingyun Liu Cyrus R. Mehta 《Biometrical journal. Biometrische Zeitschrift》2019,61(5):1175-1186
Clinical trials with adaptive sample size reassessment based on an unblinded analysis of interim results are perhaps the most popular class of adaptive designs (see Elsäßer et al., 2007). Such trials are typically designed by prespecifying a zone for the interim test statistic, termed the promising zone, along with a decision rule for increasing the sample size within that zone. Mehta and Pocock (2011) provided some examples of promising zone designs and discussed several procedures for controlling their type‐1 error. They did not, however, address how to choose the promising zone or the corresponding sample size reassessment rule, and proposed instead that the operating characteristics of alternative promising zone designs could be compared by simulation. Jennison and Turnbull (2015) developed an approach based on maximizing expected utility whereby one could evaluate alternative promising zone designs relative to a gold‐standard optimal design. In this paper, we show how, by eliciting a few preferences from the trial sponsor, one can construct promising zone designs that are both intuitive and achieve the Jennison and Turnbull (2015) gold‐standard for optimality. 相似文献