Asymptotic Distribution of Score Statistics for Spatial Cluster Detection with Censored Data

Summary Cook, Gold, and Li (2007, Biometrics 63, 540–549) extended the Kulldorff (1997, Communications in Statistics 26, 1481–1496) scan statistic for spatial cluster detection to survival‐type observations. Their approach was based on the score statistic and they proposed a permutation distribution for the maximum of score tests. The score statistic makes it possible to apply the scan statistic idea to models including explanatory variables. However, we show that the permutation distribution requires strong assumptions of independence between potential cluster and both censoring and explanatory variables. In contrast, we present an approach using the asymptotic distribution of the maximum of score statistics in a manner not requiring these assumptions.     

The Relative Power of Two Asymptotic Multivariate Tests for Homogeneity in a Contingency Table

In a three way contingency table two multivariate tests for homogeneity have been proposed by the author (1983) a the “catanova” test, which is a trace “metric” test and b the “multinova” test which is determinant based. Both tests are asymptotically distributed as chi-square. In this paper, the power values of the tests are compared and conditions are given for preference of each test.     

Testing threshold and hormesis in a random effects dose-response model applied to developmental toxicity data

Here we describe a random effects threshold dose-response model for clustered binary-response data from developmental toxicity studies. For our model we assume that a hormetic effect occurs in addition to a threshold effect. Therefore, the dose-response curve is based on two components: relationships below the threshold (hormetic u-shaped model) and those above the threshold (logistic model). In the absence of hormesis and threshold effects, the estimation procedure is straightforward. We introduce score tests that are derived from a random effects hormetic-threshold dose-response model. The model and tests are applied to clustered binary data from developmental toxicity studies of animals to test for hormesis and threshold effects. We also compare the score test and likelihood ratio test to test for hormesis and threshold effects in a simulated study.     

Confidence Interval for Rate Ratio in a 2 × 2 Table with Structural Zero: An Application in Assessing False-Negative Rate Ratio When Combining Two Diagnostic Tests

Summary . In this article, we consider problems with correlated data that can be summarized in a 2 × 2 table with structural zero in one of the off‐diagonal cells. Data of this kind sometimes appear in infectious disease studies and two‐step procedure studies. Lui (1998, Biometrics 54, 706–711) considered confidence interval estimation of rate ratio based on Fieller‐type, Wald‐type, and logarithmic transformation statistics. We reexamine the same problem under the context of confidence interval construction on false‐negative rate ratio in diagnostic performance when combining two diagnostic tests. We propose a score statistic for testing the null hypothesis of nonunity false‐negative rate ratio. Score test–based confidence interval construction for false‐negative rate ratio will also be discussed. Simulation studies are conducted to compare the performance of the new derived score test statistic and existing statistics for small to moderate sample sizes. In terms of confidence interval construction, our asymptotic score test–based confidence interval estimator possesses significantly shorter expected width with coverage probability being close to the anticipated confidence level. In terms of hypothesis testing, our asymptotic score test procedure has actual type I error rate close to the pre‐assigned nominal level. We illustrate our methodologies with real examples from a clinical laboratory study and a cancer study.     

On Testing for Equicorrelation in Random Coefficient Models

Recently BHATTI (1993) considered an efficient estimation of random coefficient model based on survey data. The main objective of this paper is to construct one sided test for testing equicorrelation coefficient in presence of random coefficients using optimal testing procedure. The test statistic is a ratio of quadratic forms in normal variables which is most powerful and point optimal invariant.     

A Monte Carlo Test for Variance Homogeneity in Linear Models

A Monte Carlo procedure is proposed for testing homogeneity of variances in linear models. The method is applicable to a variety of common experimental designs. It is valid when errors are independently normally distributed. Under nonnormality the test is expected to behave robust in a similar fashion as Levene's test. Three examples are given to demonstrate the method.     

A Score Test for Association of a Longitudinal Marker and an Event with Missing Data

Summary : Often clinical studies periodically record information on disease progression as well as results from laboratory studies that are believed to reflect the progressing stages of the disease. A primary aim of such a study is to determine the relationship between the lab measurements and a disease progression. If there were no missing or censored data, these analyses would be straightforward. However, often patients miss visits, and return after their disease has progressed. In this case, not only is their progression time interval censored, but their lab test series is also incomplete. In this article, we propose a simple test for the association between a longitudinal marker and an event time from incomplete data. We derive the test using a very intuitive technique of calculating the expected complete data score conditional on the observed incomplete data (conditional expected score test, CEST). The problem was motivated by data from an observational study of patients with diabetes.     

Weighted Likelihood Method for Grouped Survival Data in Case–Cohort Studies with Application to HIV Vaccine Trials

Summary Grouped failure time data arise often in HIV studies. In a recent preventive HIV vaccine efficacy trial, immune responses generated by the vaccine were measured from a case–cohort sample of vaccine recipients, who were subsequently evaluated for the study endpoint of HIV infection at prespecified follow‐up visits. Gilbert et al. (2005, Journal of Infectious Diseases 191 , 666–677) and Forthal et al. (2007, Journal of Immunology 178, 6596–6603) analyzed the association between the immune responses and HIV incidence with a Cox proportional hazards model, treating the HIV infection diagnosis time as a right‐censored random variable. The data, however, are of the form of grouped failure time data with case–cohort covariate sampling, and we propose an inverse selection probability‐weighted likelihood method for fitting the Cox model to these data. The method allows covariates to be time dependent, and uses multiple imputation to accommodate covariate data that are missing at random. We establish asymptotic properties of the proposed estimators, and present simulation results showing their good finite sample performance. We apply the method to the HIV vaccine trial data, showing that higher antibody levels are associated with a lower hazard of HIV infection.     

Comparison of Linear,Nonlinear and Semiparametric Mixed‐effects Models for Estimating HIV Dynamic Parameters

The potency of antiretroviral agents in AIDS clinical trials can be assessed on the basis of an early viral response such as viral decay rate or change in viral load (number of copies of HIV RNA) of the plasma. Linear, parametric nonlinear, and semiparametric nonlinear mixed‐effects models have been proposed to estimate viral decay rates in viral dynamic models. However, before applying these models to clinical data, a critical question that remains to be addressed is whether these models produce coherent estimates of viral decay rates, and if not, which model is appropriate and should be used in practice. In this paper, we applied these models to data from an AIDS clinical trial of potent antiviral treatments and found significant incongruity in the estimated rates of reduction in viral load. Simulation studies indicated that reliable estimates of viral decay rate were obtained by using the parametric and semiparametric nonlinear mixed‐effects models. Our analysis also indicated that the decay rates estimated by using linear mixed‐effects models should be interpreted differently from those estimated by using nonlinear mixed‐effects models. The semiparametric nonlinear mixed‐effects model is preferred to other models because arbitrary data truncation is not needed. Based on real data analysis and simulation studies, we provide guidelines for estimating viral decay rates from clinical data. (© 2004 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

Missing covariates in longitudinal data with informative dropouts: bias analysis and inference

We consider estimation in generalized linear mixed models (GLMM) for longitudinal data with informative dropouts. At the time a unit drops out, time-varying covariates are often unobserved in addition to the missing outcome. However, existing informative dropout models typically require covariates to be completely observed. This assumption is not realistic in the presence of time-varying covariates. In this article, we first study the asymptotic bias that would result from applying existing methods, where missing time-varying covariates are handled using naive approaches, which include: (1) using only baseline values; (2) carrying forward the last observation; and (3) assuming the missing data are ignorable. Our asymptotic bias analysis shows that these naive approaches yield inconsistent estimators of model parameters. We next propose a selection/transition model that allows covariates to be missing in addition to the outcome variable at the time of dropout. The EM algorithm is used for inference in the proposed model. Data from a longitudinal study of human immunodeficiency virus (HIV)-infected women are used to illustrate the methodology.     

Using Regression Models to Analyze Randomized Trials: Asymptotically Valid Hypothesis Tests Despite Incorrectly Specified Models

Summary .  Regression models are often used to test for cause-effect relationships from data collected in randomized trials or experiments. This practice has deservedly come under heavy scrutiny, because commonly used models such as linear and logistic regression will often not capture the actual relationships between variables, and incorrectly specified models potentially lead to incorrect conclusions. In this article, we focus on hypothesis tests of whether the treatment given in a randomized trial has any effect on the mean of the primary outcome, within strata of baseline variables such as age, sex, and health status. Our primary concern is ensuring that such hypothesis tests have correct type I error for large samples. Our main result is that for a surprisingly large class of commonly used regression models, standard regression-based hypothesis tests (but using robust variance estimators) are guaranteed to have correct type I error for large samples, even when the models are incorrectly specified. To the best of our knowledge, this robustness of such model-based hypothesis tests to incorrectly specified models was previously unknown for Poisson regression models and for other commonly used models we consider. Our results have practical implications for understanding the reliability of commonly used, model-based tests for analyzing randomized trials.     

Finite Sample Properties of the Maximum Likelihood Estimator and of Likelihood Ratio Tests in Hidden Markov Models

Hidden Markov models were successfully applied in various fields of time series analysis, especially for analyzing ion channel recordings. The maximum likelihood estimator (MLE) has recently been proven to be asymptotically normally distributed. Here, we investigate finite sample properties of the MLE and of different types of likelihood ratio tests (LRTs) by means of simulation studies. The MLE is shown to reach the asymptotic behavior within sample sizes that are common for various applications. Thus, reliable estimates and confidence intervals can be obtained. We give an approximative scaling function for the estimation error for finite samples, and investigate the power of different LRTs suitable for applications to ion channels, including tests for superimposed hidden Markov processes. Our results are applied to physiological sodium channel data.     

Multiple imputation approach for interval‐censored time to HIV RNA viral rebound within a mixed effects Cox model

We present a method to fit a mixed effects Cox model with interval‐censored data. Our proposal is based on a multiple imputation approach that uses the truncated Weibull distribution to replace the interval‐censored data by imputed survival times and then uses established mixed effects Cox methods for right‐censored data. Interval‐censored data were encountered in a database corresponding to a recompilation of retrospective data from eight analytical treatment interruption (ATI) studies in 158 human immunodeficiency virus (HIV) positive combination antiretroviral treatment (cART) suppressed individuals. The main variable of interest is the time to viral rebound, which is defined as the increase of serum viral load (VL) to detectable levels in a patient with previously undetectable VL, as a consequence of the interruption of cART. Another aspect of interest of the analysis is to consider the fact that the data come from different studies based on different grounds and that we have several assessments on the same patient. In order to handle this extra variability, we frame the problem into a mixed effects Cox model that considers a random intercept per subject as well as correlated random intercept and slope for pre‐cART VL per study. Our procedure has been implemented in R using two packages: truncdist and coxme , and can be applied to any data set that presents both interval‐censored survival times and a grouped data structure that could be treated as a random effect in a regression model. The properties of the parameter estimators obtained with our proposed method are addressed through a simulation study.     

Analyzing multiply matched cohort studies with two different comparison groups: application to pregnancy rates among HIV+ women

We develop a new statistical method to analyze multiply matched cohort studies with two different comparison groups. We employ a linear-logistic model to describe the underlying log-odds ratios and use a conditional likelihood approach to conduct inference. Under the assumption of homogeneous log-odds ratios, we provide methods to construct both asymptotic and exact confidence regions of the two log-odds ratios in a simple case. We propose a score test to evaluate the assumption of homogeneous log-odds ratios across strata. While our methods are general, we develop them around a specific application, namely, the study of pregnancy rates in HIV-infected women. Our analyses suggest that HIV infection is associated with a decrease in pregnancy rates and that this decrease in fertility becomes significant after accounting for illicit drug use.     

RNA-based gene therapy for the treatment and prevention of HIV: from bench to bedside

Gene therapy is considered a feasible approach for the treatment and prevention of HIV/AIDS. Targeting both viral genes and host dependency factors can interfere with the viral lifecycle and prevent viral replication. A number of approaches have been taken to target these genes, including ribozymes, aptamers, and RNAi based therapies. A number of these therapies are now beginning to make their way into clinical trials and providing proof of principle that gene therapy is a safe and realistic option for treating HIV. Here, we focus on those therapies that have progressed along the pipeline to preclinical and clinical testing.