Sample size determination for case-control studies and the comparison of stratified and unstratified analyses.

Woolson, Bean, and Rojas (1986, Biometrics 42, 927-932) present a simple approximation of sample size for Cochran's (1954, Biometrics 10, 417-451) test for detecting association between exposure and disease. It is useful in the design of case-control studies. We derive a sample size formula for Cochran's statistic with continuity correction which guarantees that the actual Type I error rate of the test does not exceed the nominal level. The corrected sample size is necessarily larger than the uncorrected one given by Woolson et al. and the relative difference between the two sample sizes is considerable. Allocation of equal number of cases and controls within each stratum is asymptotically optimal when the costs per case and control are the same. When any effect of stratification is absent, Cochran's stratified test, although valid, is less efficient than the unstratified one except for the important case of a balanced design.     

A simple approximation for calculating sample sizes for detecting linear trend in proportions

A simple approximate formula for sample sizes for detecting a linear trend in proportions is derived. The formulas for both the uncorrected and corrected Cochran-Armitage test are given. For two binomial proportions these reduce to those given by Casagrande, Pike, and Smith (1978, Biometrics 34, 483-486). Some numerical results of a power study for small sample sizes show that the nominal power corresponding to the approximate sample size is a reasonably good approximation to the actual power.     

On sample size and inference for two-stage adaptive designs

Proschan and Hunsberger (1995, Biometrics 51, 1315-1324) proposed a two-stage adaptive design that maintains the Type I error rate. For practical applications, a two-stage adaptive design is also required to achieve a desired statistical power while limiting the maximum overall sample size. In our proposal, a two-stage adaptive design is comprised of a main stage and an extension stage, where the main stage has sufficient power to reject the null under the anticipated effect size and the extension stage allows increasing the sample size in case the true effect size is smaller than anticipated. For statistical inference, methods for obtaining the overall adjusted p-value, point estimate and confidence intervals are developed. An exact two-stage test procedure is also outlined for robust inference.     

On power and sample size calculations for likelihood ratio tests in generalized linear models

A direct extension of the approach described in Self, Mauritsen, and Ohara (1992, Biometrics 48, 31-39) for power and sample size calculations in generalized linear models is presented. The major feature of the proposed approach is that the modification accommodates both a finite and an infinite number of covariate configurations. Furthermore, for the approximation of the noncentrality of the noncentral chi-square distribution for the likelihood ratio statistic, a simplification is provided that not only reduces substantial computation but also maintains the accuracy. Simulation studies are conducted to assess the accuracy for various model configurations and covariate distributions.     

Bootstrap tests for overdispersion in a zero-inflated Poisson regression model

Ridout, Hinde, and Demétrio (2001, Biometrics 57, 219-223) derived a score test for testing a zero-inflated Poisson (ZIP) regression model against zero-inflated negative binomial (ZINB) alternatives. They mentioned that the score test using the normal approximation might underestimate the nominal significance level possibly for small sample cases. To remedy this problem, a parametric bootstrap method is proposed. It is shown that the bootstrap method keeps the significance level close to the nominal one and has greater power uniformly than the existing normal approximation for testing the hypothesis.     

Sample size for case-control studies using Cochran's statistic

Sample size determination for case-control studies of chronic disease are often based on the simple 2 X 2 tabular cross-classification of exposure and disease, thereby ignoring stratification which may be considered in the analysis. One consequence of this approach is that the sample size may be inadequate to attain a specified power and size when performing a statistical analysis on J 2 X 2 tables using Cochran's (1954, Biometrics 10, 417-451) statistic or the Mantel-Haenszel (1959, Journal of the National Cancer Institute 22, 719-748) statistic. A sample size formula is derived from Cochran's statistic and it is compared with the corresponding one derived when the data are treated as unstratified, and also with two other formulas proposed for stratified data analysis. The formula developed yields values slightly higher than one recently proposed by Mu?oz and Rosner (1984, Biometrics 40, 995-1004), which assumes that both margins of each 2 X 2 table are fixed, while the present study considers only the case-control margin to be fixed.     

Asymptotic distribution of an index for disease clustering

Tango (1984, Biometrics 40, 15-26) proposed an index for disease clustering in time, applicable to grouped data with the assumption that the population at risk remains fairly uniform over the study period. However, the asymptotic distribution of the index derived under the hypothesis of no clustering was rather complex for simple use. Recently, Whittemore and Keller (1986, Biometrics 42, 218) and Whittemore et al. (1987, Biometrika 74, 631-635) proved that the distribution of the index is asymptotically normal. The present paper indicates that their approximation may be poor for moderately large sample sizes and suggests a central chi-square distribution as a better approximation to the asymptotic distribution of this index.     

A case-cohort design for assessing covariate effects in longitudinal studies

The case-cohort design for longitudinal data consists of a subcohort sampled at the beginning of the study that is followed repeatedly over time, and a case sample that is ascertained through the course of the study. Although some members in the subcohort may experience events over the study period, we refer to it as the "control-cohort." The case sample is a random sample of subjects not in the control-cohort, who have experienced at least one event during the study period. Different correlations among repeated observations on the same individual are accommodated by a two-level random-effects model. This design allows consistent estimation of all parameters estimable in a cohort design and is a cost-effective way to study the effects of covariates on repeated observations of relatively rare binary outcomes when exposure assessment is expensive. It is an extension of the case-cohort design (Prentice, 1986, Biometrika73, 1-11) and the bidirectional case-crossover design (Navidi, 1998, Biometrics54, 596-605). A simulation study compares the efficiency of the longitudinal case-cohort design to a full cohort analysis, and we find that in certain situations up to 90% efficiency can be obtained with half the sample size required for a full cohort analysis. A bootstrap method is presented that permits testing for intra-subject homogeneity in the presence of unidentifiable nuisance parameters in the two-level random-effects model. As an illustration we apply the design to data from an ongoing study of childhood asthma.     

Power and sample size estimation for the clustered wilcoxon test

The Wilcoxon rank sum test is widely used for two-group comparisons of nonnormal data. An assumption of this test is independence of sampling units both within and between groups, which will be violated in the clustered data setting such as in ophthalmological clinical trials, where the unit of randomization is the subject, but the unit of analysis is the individual eye. For this purpose, we have proposed the clustered Wilcoxon test to account for clustering among multiple subunits within the same cluster (Rosner, Glynn, and Lee, 2003, Biometrics 59, 1089-1098; 2006, Biometrics 62, 1251-1259). However, power estimation is needed to plan studies that use this analytic approach. We have recently published methods for estimating power and sample size for the ordinary Wilcoxon rank sum test (Rosner and Glynn, 2009, Biometrics 65, 188-197). In this article we present extensions of this approach to estimate power for the clustered Wilcoxon test. Simulation studies show a good agreement between estimated and empirical power. These methods are illustrated with examples from randomized trials in ophthalmology. Enhanced power is achieved with use of the subunit as the unit of analysis instead of the cluster using the ordinary Wilcoxon rank sum test.     

Approaches for calculating power for case-cohort studies

An approach for determining the power of a case-cohort study for a single binary exposure variable and a low failure rate was recently proposed by Cai and Zeng (2004, Biometrics 60, 1015-1024). In this article, we show that computing power for a case-cohort study using a standard case-control method yields nearly identical levels of power. An advantage of the case-control approach is that existing sample size software can be used for the calculations. We also propose an additional formula for computing the power of a case-cohort study for the situation when the event is not rare.     

Modification of the computational procedure in Parker and Bregman's method of calculating sample size from matched case-control studies with a dichotomous exposure

Several authors have addressed the problem of calculating sample size for a matched case-control study with a dichotomous exposure. The approach of Parker and Bregman (1986, Biometrics42, 919-926) is, in our view, one of the most satisfactory, since it requires specification of quantities that are often easily available to the investigator. However, its recommended implementation involves a computational approximation. We show here that the approximation performs poorly in extreme situations and can be easily replaced with a more exact calculation.     

A note on the tests for clustered matched-pair binary data

McNemar's test is used to assess the difference between two different procedures (treatments) using independent matched-pair data. For matched-pair data collected in clusters, the tests proposed by Durkalski et al. and Obuchowski are popular and commonly used in practice since these tests do not require distributional assumptions or assumptions on the structure of the within-cluster correlation of the data. Motivated by these tests, this note proposes a modified Obuchowski test and illustrates comparisons of the proposed test with the extant methods. An extensive Monte Carlo simulation study suggests that the proposed test performs well with respect to the nominal size, and has higher power; Obuchowski's test is most conservative, and the performance of the Durkalski's test varies between the modified Obuchowski test and the original Obuchowski's test. These results form the basis for our recommendation that (i) for equal cluster size, the modified Obuchowski test is always preferred; (ii) for varying cluster size Durkalski's test can be used for a small number of clusters (e.g. K < 50), whereas for a large number of clusters (e.g. K ≥ 50) the modified Obuchowski test is preferred. Finally, to illustrate practical application of the competing tests, two real collections of clustered matched-pair data are analyzed.     

On comparison of mixture models for closed population capture-recapture studies

Summary .  A mixture model is a natural choice to deal with individual heterogeneity in capture–recapture studies. Pledger (2000, Biometrics 56, 434–442; 2005, Biometrics 61, 868–876) advertised the use of the two-point mixture model. Dorazio and Royle (2003, Biometrics 59, 351–364; 2005, Biometrics 61, 874–876) suggested that the beta-binomial model has advantages. The controversy is related to the nonidentifiability of the population size ( Link, 2003 , Biometrics 59, 1123–1130) and certain boundary problems. The total bias is decomposed into an intrinsic bias, an approximation bias, and an estimation bias. We propose to assess the approximation bias, the estimation bias, and the variance, with the intrinsic bias excluded when comparing different estimators. The boundary problems in both models and their impacts are investigated. Real epidemiological and ecological examples are analyzed.     

Data adaptive interim modification of sample sizes for candidate-gene association studies

OBJECTIVES: The use of conventional Transmission/Disequilibrium tests in the analysis of candidate-gene association studies requires the precise and complete pre-specification of the total number of trios to be sampled to obtain sufficient power at a certain significance level (type I error risk). In most of these studies, very little information about the genetic effect size will be available beforehand and thus it will be difficult to calculate a reasonable sample size. One would therefore wish to reassess the sample size during the course of a study. METHOD: We propose an adaptive group sequential procedure which allows for both early stopping of the study with rejection of the null hypothesis (H0) and for recalculation of the sample size based on interim effect size estimates when H0 cannot be rejected. The applicability of the method which was developed by Müller and Sch?fer [Biometrics 2001;57:886-891] in a clinical context is demonstrated by a numerical example. Monte Carlo simulations are performed comparing the adaptive procedure with a fixed sample and a conventional group sequential design. RESULTS: The main advantage of the adaptive procedure is its flexibility to allow for design changes in order to achieve a stabilized power characteristic while controlling the overall type I error and using the information already collected. CONCLUSIONS: Given these advantages, the procedure is a promising alternative to traditional designs.     

Non-inferiority of new procedure to standard procedure in stratified matched-pair design

We consider the statistical testing for non-inferiority of a new treatment compared with the standard one under matched-pair setting in a stratified study or in several trials. A non-inferiority test based on the efficient scores and a Mantel-Haenszel (M-H) like procedure with restricted maximum likelihood estimators (RMLEs) of nuisance parameters and their corresponding sample size formulae are presented. We evaluate the above tests and the M-H type Wald test in level and power. The stratified score test is conservative and provides the best power. The M-H like procedure with RMLEs gives an accurate level. However, the Wald test is anti-conservative and we suggest caution when it is used. The unstratified score test is not biased but it is less powerful than the stratified score test when base-line probabilities related to strata are not the same. This investigation shows that the stratified score test possesses optimum statistical properties in testing non-inferiority. A common difference between two proportions across strata is the basic assumption of the stratified tests, we present appropriate tests to validate the assumption and related remarks.     

Homogeneity test of rate ratios in stratified matched-pair studies

This paper investigates homogeneity test of rate ratios in stratified matched-pair studies on the basis of asymptotic and bootstrap-resampling methods. Based on the efficient score approach, we develop a simple and computationally tractable score test statistic. Several other homogeneity test statistics are also proposed on the basis of the weighted least-squares estimate and logarithmic transformation. Sample size formulae are derived to guarantee a pre-specified power for the proposed tests at the pre-given significance level. Empirical results confirm that (i) the modified score statistic based on the bootstrap-resampling method performs better in the sense that its empirical type I error rate is much closer to the pre-specified nominal level than those of other tests and its power is greater than those of other tests, and is hence recommended, whilst the statistics based on the weighted least-squares estimate and logarithmic transformation are slightly conservative under some of the considered settings; (ii) the derived sample size formulae are rather accurate in the sense that their empirical powers obtained from the estimated sample sizes are very close to the pre-specified nominal powers. A real example is used to illustrate the proposed methodologies.     

Multipoint linkage detection in the presence of heterogeneity

Linkage heterogeneity is common for complex diseases. It is well known that loss of statistical power for detecting linkage will result if one assumes complete homogeneity in the presence of linkage heterogeneity. To this end, Smith (1963, Annals of Human Genetics 27, 175-182) proposed an admixture model to account for linkage heterogeneity. It is well known that for this model, the conventional chi-squared approximation to the likelihood ratio test for no linkage does not apply even when the sample size is large. By dealing with nuclear families and one marker at a time for genetic diseases with simple modes of inheritance, score-based test statistics (Liang and Rathouz, 1999, Biometrics 55, 65-74) and likelihood-ratio-based test statistics (Lemdani and Pons, 1995, Biometrics 51, 1033-1041) have been proposed which have a simple large-sample distribution under the null hypothesis of linkage. In this paper, we extend their work to more practical situations that include information from multiple markers and multi-generational pedigrees while allowing for a class of general genetic models. Three different approaches are proposed to eliminate the nuisance parameters in these test statistics. We show that all three approaches lead to the same asymptotic distribution under the null hypothesis of no linkage. Simulation results show that the proposed test statistics have adequate power to detect linkage and that the performances of these two classes of test statistics are quite comparable. We have applied the proposed method to a family study of asthma (Barnes et al., 1996), in which the score-based test shows evidence of linkage with p-value <0.0001 in the region of interest on chromosome 12. Additionally, we have implemented this score-based test within the frequently used computer package GENEHUNTER.     

Minimax D-optimal designs for the logistic model

We propose an algorithm for constructing minimax D-optimal designs for the logistic model when only the ranges of the values for both parameters are assumed known. Properties of these designs are studied and compared with optimal Bayesian designs and Sitter's (1992, Biometrics, 48, 1145-1155) minimax D-optimal kk-designs. Examples of minimax D-optimal designs are presented for the logistic and power logistic models, including a dose-response design for rheumatoid arthritis patients.     

Approaches for Calculating Power for Case–Cohort Studies

Summary .   An approach for determining the power of a case–cohort study for a single binary exposure variable and a low failure rate was recently proposed by Cai and Zeng (2004, Biometrics 60, 1015–1024). In this article, we show that computing power for a case–cohort study using a standard case–control method yields nearly identical levels of power. An advantage of the case–control approach is that existing sample size software can be used for the calculations. We also propose an additional formula for computing the power of a case–cohort study for the situation when the event is not rare.     

Using Weighted Kaplan-Meier Statistics in Nonparametric Comparisons of Paired Censored Survival Outcomes

This research introduces methods for nonparametric testing of weighted integrated survival differences in the context of paired censored survival designs. The current work extends work done by Pepe and Fleming (1989, Biometrics 45, 497-507), which considered similar test statistics directed toward independent treatment group comparisons. An asymptotic closed-form distribution of the proposed family of tests is presented, along with variance estimates constructed under null and alternative hypotheses using nonparametric maximum likelihood estimates of the closed-form quantities. The described method allows for additional information from individuals with no corresponding matched pair member to be incorporated into the test statistic in sampling scenarios where singletons are not prone to selection bias. Simulations presented over a range of potential dependence in the paired censored survival data demonstrate substantial power gains associated with taking into account the dependence structure. Consequences of ignoring the paired nature of the data include overly conservative tests in terms of power and size. In fact, simulation results using tests for independent samples in the presence of positive correlation consistently undershot both size and power targets that would have been attained in the absence of correlation. This additional worrisome effect on operating characteristics highlights the need for accounting for dependence in this popular family of tests.