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Editor’s Note: Special Section on Estimands, Design and Analysis of Clinical Trials with Time-to-Event Outcomes 编者注:具有事件发生时间结果的临床试验的估计、设计和分析的特别部分
IF 1.8 4区 医学 Q2 Mathematics Pub Date : 2023-04-03 DOI: 10.1080/19466315.2023.2200113
T. Hamasaki
In several disease areas, such as cardiovascular disease, oncology/cancer or HIV, clinical trials often collect and analyze multiple time-to-event (or survival) outcomes from patients to assess the effects of interventions. Methods for time-to-event outcomes are more complex than for binary or continuous outcomes. The design, monitoring, analysis and reporting of clinical trials with time-to-event outcomes (time-to-event clinical trials) will require considerable care. A common practice in time-to-event clinical trials is to first create a composite endpoint that combines several clinically relevant time-to-event outcomes (e.g., major adverse cardiovascular events (MACE), consisting of death, myocardial infarction, and stroke in cardiovascular disease; progression free survival (PFS) consisting of time-to-progression and overall survival), and then to perform a time-to-first-event analysis for the composite endpoint. The advantages and challenges of using composite endpoints are well known and have been discussed in the statistical and medical literature. Recently, many statisticians have attempted to redefine the estimand(s) of interest to capture the effects of interventions and the corresponding estimators of the estimand(s) (statistical methods) since the implementation of the estimand framework highlighted in the ICH-E9(R1) guideline (ICH 2019). Common survival analysis methods, such as Kaplan-Meier method, log-rank test, or Cox proportional hazards regression, have many strengths and are well accepted in practice. However, there are situations in which they may not be feasible or provide reliable results. The common methods are based
在一些疾病领域,如心血管疾病、肿瘤/癌症或艾滋病毒,临床试验通常收集和分析患者的多次事件(或生存)结果,以评估干预措施的效果。时间到事件结果的方法比二元或连续结果的方法更复杂。设计、监测、分析和报告具有事件发生时间结果的临床试验(事件发生时间临床试验)将需要相当谨慎。在事件发生时间临床试验中,一种常见的做法是首先创建一个复合终点,该终点结合了几个临床相关的事件发生时间结局(例如,心血管疾病中的主要不良事件(MACE),包括死亡、心肌梗死和中风;无进展生存期(PFS),包括进展时间和总生存期),然后对复合终点进行首次事件时间分析。使用复合终点的优点和挑战是众所周知的,并在统计和医学文献中进行了讨论。最近,自ICH- e9 (R1)指南(ICH 2019)中强调的估计框架实施以来,许多统计学家试图重新定义感兴趣的估计,以捕获干预措施的效果和相应的估计量(统计方法)。常见的生存分析方法,如Kaplan-Meier法、log-rank检验、Cox比例风险回归等,有很多优点,在实践中被广泛接受。然而,在某些情况下,它们可能不可行或不能提供可靠的结果。常用的方法是基于
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引用次数: 0
Rejoinder to Comments on “Non-Proportional Hazards – An Evaluation of the MaxCombo Test in Cancer Clinical Trials” 对“非比例风险——对MaxCombo试验在癌症临床试验中的评价”评论的答复
IF 1.8 4区 医学 Q2 Mathematics Pub Date : 2023-04-03 DOI: 10.1080/19466315.2023.2203007
Y. Shen, Sirisha L. Mushti, Flora Mulkey, T. Gwise, Xin Wang, Jiaxi Zhou, Xin Gao, Shenghui Tang, M. Theoret, R. Pazdur, R. Sridhara
This rejoinder continues a discussion initiated by the Oncology Center of Excellence’s call (2016–2017) for statistical approaches to address the problem of assessing treatment effects in the presence of non-proportional hazards (NPH) (Duke-Margolis Workshop 2018; Lin et al. 2020a, Lin et al. 2020b; Roychoudhury et al. 2021). The publication of the method was met with much discussion, several commentary articles (Freidlin and Korn 2019; Bartlett et al. 2020; Lin et al. 2020a; Magirr and Burman 2021; Roychoudhury et al. 2021) and a rejoinder by the MaxCombo test coauthors (Lin et al. 2020b). After consideration of the proposed method and review of its accompanying responses and rejoinder, we expressed our views on the MaxCombo tests and provided general thoughts on design issues when NPH is expected in our article (Shen et al. 2021). In response to the publication of our article, the Cross-PhRMA working group (Lin et al. 2023) and Posch, Ristl, and König (2022) published additional commentary providing further clarification and views. We appreciate the great interest in NPH issues in the regulatory statistical community and would like to take this opportunity to provide additional clarifications and comments. Although the primary objective of our 2021 article was to focus on the MaxCombo test, as noted by Lin et al. (2023), a number of the issues are more general and are equally applicable when using many other methods and testing statistics, for example, the difficulty in interpretation or failure to incorporate underlying reasons of NPH. In fact, recognizing the shortcomings of the more commonly used tests such as log-rank test, etc., FDA initiated the dialogue and invited PhRMA to come together to develop methodology to address this issue. The MaxCombo test is presented as representing a flexible testing procedure impervious to a variety of shapes of curves under NPH. Cross-PhRMA working group suggested a 3-step method for evaluation of treatment effect when NPH is expected (Lin et al. 2020a, Lin et al. 2020b, Roychoudhury et al. 2021). Lin et al. (2023) clarified that in this scenario, a successful treatment effect would not be claimed based solely on results from the MaxCombo test, as the Cross-PhRMA working group recommends such decisions be based on the totality of data
该反驳继续了肿瘤卓越中心(2016-2017)发起的关于统计方法的讨论,以解决在存在非比例风险(NPH)的情况下评估治疗效果的问题(Duke-Margolis Workshop 2018;Lin et al. 2020a, Lin et al. 2020b;Roychoudhury et al. 2021)。该方法的发表引起了很多讨论,几篇评论文章(Freidlin and Korn 2019;Bartlett et al. 2020;Lin等。2020a;Magirr and Burman 2021;Roychoudhury等人,2021)和MaxCombo测试合著者的反驳(Lin等人,2020b)。在考虑了提议的方法并审查了相关的回应和反驳后,我们在文章中表达了我们对MaxCombo测试的看法,并就NPH预期时的设计问题提供了总体思路(Shen et al. 2021)。作为对我们文章发表的回应,Cross-PhRMA工作组(Lin et al. 2023)、Posch、Ristl和König(2022)发表了额外的评论,提供了进一步的澄清和观点。我们感谢监管统计界对NPH问题的极大兴趣,并希望借此机会提供额外的澄清和评论。正如Lin等人(2023)所指出的,尽管我们2021年文章的主要目标是关注MaxCombo测试,但许多问题更为普遍,在使用许多其他方法和测试统计数据时同样适用,例如,难以解释或未能纳入NPH的潜在原因。事实上,认识到更常用的测试(如log-rank测试等)的缺点,FDA发起了对话,并邀请PhRMA一起制定解决这一问题的方法。MaxCombo测试代表了一种灵活的测试程序,不受NPH下各种形状曲线的影响。跨phrma工作组提出了一种评估NPH预期治疗效果的三步法(Lin et al. 2020a, Lin et al. 2020b, Roychoudhury et al. 2021)。Lin等人(2023)澄清说,在这种情况下,不能仅仅根据MaxCombo测试的结果来宣称成功的治疗效果,因为Cross-PhRMA工作组建议基于整体数据做出此类决定
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引用次数: 0
Comment on “Non-Proportional Hazards – an Evaluation of the MaxCombo Test in Cancer Clinical Trials” by the Cross-Pharma Non-Proportional Hazards Working Group 跨制药非比例风险工作组对“非比例风险——对MaxCombo试验在癌症临床试验中的评价”的评论
IF 1.8 4区 医学 Q2 Mathematics Pub Date : 2023-04-03 DOI: 10.1080/19466315.2022.2103180
Ray S. Lin, P. Mukhopadhyay, Satrajit Roychoudhury, K. Anderson, Tianle Hu, Bo Huang, L. F. León, J. Liao, Ji Lin, Rong Liu, Xiaodong Luo, Yabing Mai, R. Qin, K. Tatsuoka, Yang Wang, Jiabu Ye, Jian Zhu, Tai-Tsang Chen, R. Iacona
aGenentech/Roche, South San Francisco, CA; bOtsuka America Pharmaceuticals, Inc, Rockville, MD, 20850; cPfizer Inc, New York, NY; dMerck & Co., Inc, Kenilworth, NJ; eSarepta Therapeutics, Cambridge, MA; fPfizer Inc, Groton, CT; gIncyte Corporation, Wilmington, DE; hSanofi US, Cambridge, MA; iBristolMyers Squibb, Berkeley Heights, NJ; jSanofi US, Bridgewater, NJ; kBoehringer Ingelheim, Shanghai, China; lJanssen Research & Development, LLC, Raritan, NJ; mSanten Pharmaceuticals, Emeryville, CA; nZ&W Consulting, Chester Springs, PA; oServier Pharmaceuticals, Boston, MA; pGSK, Collegeville, PA; qAstra Zeneca, Washington, DC; rThe Cross-Pharma NPH working group includes all the authors of this manuscript as listed above and the following members who have contributed tremendously to this work: Prabhu Bhagavatheeswaran, Julie Cong, Margarida Geraldes, Dominik Heinzmann, Yifan Huang, Zhengrong Li, Honglu Liu, Jane Qian, Xuejing Wang, Li-an Xu, Luping Zhao
aGenentech/Roche,南旧金山,加利福尼亚州;bOtsuka America Pharmaceuticals, Inc ., Rockville, MD, 20850;纽约cpizer公司;d默克公司,新泽西州凯尼尔沃斯;eSarepta Therapeutics, Cambridge, MA;辉瑞公司,格罗顿,康涅狄格州;gIncyte Corporation, Wilmington, DE;赛诺菲美国,剑桥,马萨诸塞州;bristol myers Squibb,伯克利高地,新泽西;赛诺菲美国,布里奇沃特,新泽西;勃林格殷格翰,上海,中国;janssen Research & Development, LLC, NJ;santen制药公司,加利福尼亚州埃默里维尔;nZ&W咨询公司,切斯特斯普林斯,宾夕法尼亚州;oServier Pharmaceuticals, Boston, MA;pGSK,学院维尔,宾夕法尼亚州;qAstra Zeneca,华盛顿特区;rcross - pharma NPH工作组包括上述手稿的所有作者以及以下对这项工作做出巨大贡献的成员:Prabhu Bhagavatheeswaran, Julie丛婧,Margarida Geraldes, Dominik Heinzmann,黄一凡,李正容,刘洪路,钱简,王学静,徐丽安,赵鲁平
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引用次数: 1
We Need Subject Matter Expertise to Choose and Identify Causal Estimands: Comment on “Estimands for Recurrent Event Endpoints in the Presence of a Terminal Event” 我们需要主题专业知识来选择和识别因果估计:评论“在终端事件存在的情况下对重复事件终点的估计”
IF 1.8 4区 医学 Q2 Mathematics Pub Date : 2023-04-03 DOI: 10.1080/19466315.2022.2108138
Matias Janvin, Jessica G. Young, M. J. Stensrud
Abstract We summarize what we consider to be the two main limitations of the “Estimands for Recurrent Event Endpoints in the Presence of a Terminal Event” (Schmidli et al. 2022). First, the authors did not give detailed guidance on how to choose an appropriate estimand in light of subject-matter considerations. Reasoning about the mechanism by which treatment affects different types of events is central when selecting a causal estimand, and such reasoning can be grounded in the interventionist mediation literature. Second, the article also did not discuss the crucial task of identification when the aim is to study a causal question. Thereby, the authors omit important differences in the uncertainty of the assumptions needed to target each estimand by particular statistical methods. These assumptions have crucial implications for the confidence that can be placed in a given effect estimate, and for the planning and collection of relevant variables in the study design.
摘要我们总结了我们认为的“在终端事件存在的情况下对重复事件终点的估计”的两个主要限制(Schmidli et al. 2022)。首先,作者没有就如何根据主题事项考虑选择适当的估计给出详细的指导。在选择因果估计时,关于治疗影响不同类型事件的机制的推理是核心,这种推理可以在干预主义调解文献中建立基础。其次,本文也没有讨论识别的关键任务,当目的是研究一个因果问题。因此,作者通过特定的统计方法忽略了针对每个估计所需的假设不确定性中的重要差异。这些假设对于给定效果估计的置信度以及研究设计中相关变量的规划和收集具有至关重要的意义。
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引用次数: 1
Rejoinder to Commentaries on “Estimands for Recurrent Event Endpoints in the Presence of a Terminal Event” 对“在存在终止事件的情况下对重复事件终点的估计”评论的答复
4区 医学 Q2 Mathematics Pub Date : 2023-04-03 DOI: 10.1080/19466315.2023.2166098
Heinz Schmidli, James H. Roger, Mouna Akacha
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引用次数: 0
Statistics in Biopharmaceutical Research Best Papers Award 2023 生物制药研究统计学最佳论文奖2023
IF 1.8 4区 医学 Q2 Mathematics Pub Date : 2023-04-03 DOI: 10.1080/19466315.2023.2200112
T. Hamasaki, Freda Cooner
We are pleased to announce the recipients of the 2023 Best Paper Award for the articles published in Statistics in Biopharmaceutical Research (SBR). The following five articles were selected from those published in the 2021 and 2022 issues. These articles exhibit excellent examples of current statistical advancements in biopharmaceutical research. In selecting the winners, the editors reflected SBRs goal of publishing articles that focus on the development of novel statistical methods, advanced applications of existing methods
我们很高兴地宣布2023年最佳论文奖的获得者,他们发表在《生物制药研究统计》(SBR)上的文章。以下五篇文章是从2021年和2022年出版的文章中挑选出来的。这些文章展示了生物制药研究中当前统计进展的极好例子。在选择获奖者时,编辑们反映了sbr的目标,即发表专注于发展新颖统计方法和现有方法的先进应用的文章
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引用次数: 0
Beyond the Cox Hazard Ratio: A Targeted Learning Approach to Survival Analysis in a Cardiovascular Outcome Trial Application 超越Cox风险比:一种有针对性的学习方法在心血管结局试验中的生存分析
IF 1.8 4区 医学 Q2 Mathematics Pub Date : 2023-04-03 DOI: 10.1080/19466315.2023.2173644
David Chen, M. Petersen, H. Rytgaard, Randi Grøn, T. Lange, S. Rasmussen, R. Pratley, S. Marso, K. Kvist, J. Buse, M. J. van der Laan
Abstract The Hazard Ratio (HR) is a well-established treatment effect measure in randomized trials involving right-censored time-to-events, and the Cardiovascular Outcome Trials (CVOTs) conducted since the FDA’s 2008 guidance have indeed largely evaluated excess risk by estimating a Cox HR. On the other hand, the limitations of the Cox model and of the HR as a causal estimand are well known, and the FDA’s updated 2020 CVOT guidance invites us to reassess this default approach to survival analyses. We highlight the shortcomings of Cox HR-based analyses and present an alternative following the causal roadmap—moving in a principled way from a counterfactual causal question to identifying a statistical estimand, and finally to targeted estimation in a large statistical model. We show in simulations the robustness of Targeted Maximum Likelihood Estimation (TMLE) to informative censoring and model misspecification and demonstrate a targeted learning analogue of the original Cox HR-based analysis of the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial. We discuss the potential reliability, interpretability, and efficiency gains to be had by updating our survival methods to incorporate the recent decades of advancements in formal causal frameworks and efficient nonparametricestimation.
摘要风险比(HR)是随机试验中一个公认的治疗效果指标,涉及事件发生时间的正确审查,自美国食品药品监督管理局2008年指导意见以来进行的心血管结果试验(CVOT)确实在很大程度上通过估计Cox HR来评估过度风险。另一方面,Cox模型和HR作为因果估计的局限性是众所周知的,美国食品药品监督管理局更新的2020年CVOT指南邀请我们重新评估这种默认的生存分析方法。我们强调了基于Cox HR的分析的缺点,并提出了一种遵循因果路线图的替代方案——从反事实因果问题到确定统计估计需求,最后到在大型统计模型中进行有针对性的估计。我们在模拟中展示了目标最大似然估计(TMLE)对信息审查和模型错误指定的稳健性,并展示了对利拉鲁肽在糖尿病中的作用和作用的原始Cox-HR分析的目标学习模拟:心血管结果评估(LEADER)试验。我们讨论了通过更新我们的生存方法,结合近几十年来在形式因果框架和有效非框架估计方面的进步,可以获得的潜在可靠性、可解释性和效率收益。
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引用次数: 0
Application of group sequential methods to the 2-in-1 design and its extensions for interim monitoring 群序贯法在二合一设计中的应用及其在中期监测中的扩展
IF 1.8 4区 医学 Q2 Mathematics Pub Date : 2023-03-30 DOI: 10.1080/19466315.2023.2197402
Xuekui Zhang, Haijun Jia, Li Xing, Cong Chen
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引用次数: 3
Multiply Robust Weighted Generalized Estimating Equations for Incomplete Longitudinal Binary Data Using Empirical Likelihood 基于经验似然的不完全纵向二值数据的多重鲁棒加权广义估计方程
IF 1.8 4区 医学 Q2 Mathematics Pub Date : 2023-03-16 DOI: 10.1080/19466315.2023.2191990
Hiroshi Komazaki, Masaaki Doi, N. Yonemoto, Tosiya Sato
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引用次数: 0
Some multiplicity adjustment procedures for clinical trials with sequential design and multiple endpoints 序列设计和多终点临床试验的多重调整程序
IF 1.8 4区 医学 Q2 Mathematics Pub Date : 2023-03-16 DOI: 10.1080/19466315.2023.2191989
Xiaodong Luo, H. Quan
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引用次数: 1
期刊
Statistics in Biopharmaceutical Research
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