The Wilcoxon signed rank test for paired comparisons of clustered data

The Wilcoxon signed rank test is a frequently used nonparametric test for paired data (e.g., consisting of pre- and posttreatment measurements) based on independent units of analysis. This test cannot be used for paired comparisons arising from clustered data (e.g., if paired comparisons are available for each of two eyes of an individual). To incorporate clustering, a generalization of the randomization test formulation for the signed rank test is proposed, where the unit of randomization is at the cluster level (e.g., person), while the individual paired units of analysis are at the subunit within cluster level (e.g., eye within person). An adjusted variance estimate of the signed rank test statistic is then derived, which can be used for either balanced (same number of subunits per cluster) or unbalanced (different number of subunits per cluster) data, with an exchangeable correlation structure, with or without tied values. The resulting test statistic is shown to be asymptotically normal as the number of clusters becomes large, if the cluster size is bounded. Simulation studies are performed based on simulating correlated ranked data from a signed log-normal distribution. These studies indicate appropriate type I error for data sets with > or =20 clusters and a superior power profile compared with either the ordinary signed rank test based on the average cluster difference score or the multivariate signed rank test of Puri and Sen. Finally, the methods are illustrated with two data sets, (i) an ophthalmologic data set involving a comparison of electroretinogram (ERG) data in retinitis pigmentosa (RP) patients before and after undergoing an experimental surgical procedure, and (ii) a nutritional data set based on a randomized prospective study of nutritional supplements in RP patients where vitamin E intake outside of study capsules is compared before and after randomization to monitor compliance with nutritional protocols.     

Incorporation of clustering effects for the Wilcoxon rank sum test: a large-sample approach

The Wilcoxon rank sum test is frequently used in statistical practice for the comparison of measures of location when the underlying distributions are far from normal or not known in advance. An assumption of the ordinary rank sum test is that individual sampling units are independent. In many ophthalmologic clinical trials, the Early Treatment for Diabetic Retinopathy Scale (ETDRS) is a principal endpoint used for measuring the level of diabetic retinopathy. This is an ordinal scale, and it is natural to consider the Wilcoxon rank sum test for the comparison of the level of diabetic retinopathy between treatment groups. However, under this design, unlike the usual Wilcoxon rank sum test, the subject is the unit of randomization, but the eye is the unit of analysis. Furthermore, a person will tend to have different, but correlated, ETDRS scores for fellow eyes. Thus, we propose a correction to the variance of the Wilcoxon rank sum statistic that accounts for clustering effects and that can be used for both balanced (same number of subunits per cluster) or unbalanced (different number of subunits per cluster) data, both in the presence or absence of ties, with p-value adjusted accordingly. In this article, we present large-sample theory and simulation results for this test procedure and apply it to diabetic retinopathy data from type I diabetics in the Sorbinil Retinopathy Trial.     

A modified sign test for comparing paired ROC curves

We develop a permutation test for assessing a difference in the areas under the curve (AUCs) in a paired setting where both modalities are given to each diseased and nondiseased subject. We propose that permutations be made between subjects specifically by shuffling the diseased/nondiseased labels of the subjects within each modality. As these permutations are made within modality, the permutation test is valid even if both modalities are measured on different scales. We show that our permutation test is a sign test for the symmetry of an underlying discrete distribution whose size remains valid under the assumption of equal AUCs. We demonstrate the operating characteristics of our test via simulation and show that our test is equal in power to a permutation test recently proposed by Bandos and others (2005).     

An omnibus consistent adaptive percentile modified Wilcoxon rank sum test with applications in gene expression studies

Summary We present an adaptive percentile modified Wilcoxon rank sum test for the two‐sample problem. The test is basically a Wilcoxon rank sum test applied on a fraction of the sample observations, and the fraction is adaptively determined by the sample observations. Most of the theory is developed under a location‐shift model, but we demonstrate that the test is also meaningful for testing against more general alternatives. The test may be particularly useful for the analysis of massive datasets in which quasi‐automatic hypothesis testing is required. We investigate the power characteristics of the new test in a simulation study, and we apply the test to a microarray experiment on colorectal cancer. These empirical studies demonstrate that the new test has good overall power and that it succeeds better in finding differentially expressed genes as compared to other popular tests. We conclude that the new nonparametric test is widely applicable and that its power is comparable to the power of the Baumgartner‐Weiß‐Schindler test.     

A signed-rank test for clustered data

Summary .   We consider the problem of comparing two outcome measures when the pairs are clustered. Using the general principle of within-cluster resampling, we obtain a novel signed-rank test for clustered paired data. We show by a simple informative cluster size simulation model that only our test maintains the correct size under a null hypothesis of marginal symmetry compared to four other existing signed rank tests; further, our test has adequate power when cluster size is noninformative. In general, cluster size is informative if the distribution of pair-wise differences within a cluster depends on the cluster size. An application of our method to testing radiation toxicity trend is presented.