presents
Devan V. Mehrotra
Enhanced Analyses of Longitudinal
and Stratified Time-to-Event Clinical Trials
Abstract
In a typical comparative clinical trial, participants are randomized to
receive either an experimental or a control treatment, and the response
variable of interest (e.g., bone density) is measured at baseline and at pre-specified
post-baseline time points. The validity
of the resulting data analysis depends on whether the key underlying
assumptions are true. For example, if the
treatments are compared using a standard linear mixed effects model for the
longitudinal data, the analysis assumes that the response vector follows a
multivariate normal distribution and missing data (e.g., due to dropouts) are
"missing at random".
Similarly, in a stratified trial with a time-to-event endpoint (e.g.,
endpoint = heart attack), a key assumption in the standard stratified Cox model
analysis is that the treatment hazard ratio (HR) is constant across strata. In both these examples, even moderate violations
of the key assumptions can result in misleading conclusions. In this two-part presentation, we will demonstrate
how some standard analyses can be made stronger by weakening assumptions! In part I, we will illustrate the utility of
using multiple imputation to tackle missing values in conjunction with M-estimation
(to avoid the normality assumption) for the analysis of longitudinal clinical
trials. In part II, we will present an
efficient alternative to the stratified Cox model approach in which first the
[log] HR is estimated separately for each stratum (to avoid the stratum-invariant
HR assumption), and then the stratum-specific estimates are combined for
overall estimation and inference using either sample size or "minimum
risk" stratum weights. Real
examples and computer simulations will be used to compare the standard and new
approaches, and to reinforce the key points.
Friday, 28 October, 2011
3:00pm - 4:00pm
2203 SAS Hall