This manuscript investigates unconditional and conditional-on-stopping maximum likelihood estimators (MLEs), information measures and information loss associated with conditioning in group sequential designs (GSDs). The possibility of early stopping brings truncation to the distributional form of MLEs; sequentially, GSD decisions eliminate some events from the sample space. Multiple testing induces mixtures on the adapted sample space. Distributions of MLEs are mixtures of truncated distributions. Test statistics that are asymptotically normal without GSD, have asymptotic distributions, under GSD, that are non-normal mixtures of truncated normal distributions under local alternatives; under fixed alternatives, asymptotic distributions of test statistics are degenerate. Estimation of various statistical quantities such as information, information fractions, and confidence intervals should account for the effect of planned adaptations. Calculation of adapted information fractions requires substantial computational effort. Therefore, a new GSD is proposed in which stage-specific sample sizes are fully determined by desired operational characteristics, and calculation of information fractions is not needed.
A popular setting in medical statistics is a group sequential trial with independent and identically distributed normal outcomes, in which interim analyses of the sum of the outcomes are performed. Based on a prescribed stopping rule, one decides after each interim analysis whether the trial is stopped or continued. Consequently, the actual length of the study is a random variable. It is reported in the literature that the interim analyses may cause bias if one uses the ordinary sample mean to estimate the location parameter. For a generic stopping rule, which contains many classical stopping …
Sequential likelihood ratio testing is found to be most powerful in sequential studies with early stopping rules when grouped data come from the one-parameter exponential family. First, to obtain this elusive result, the probability measure of a group sequential design is constructed with support for all possible outcome events, as is useful for designing an experiment prior to having data. This construction identifies impossible events that are not part of the support. The overall probability distribution is dissected into stage specific components. These components are sub-densities of inter…
A sequential multiple assignment randomized trial (SMART) facilitates comparison of multiple adaptive treatment strategies (ATSs) simultaneously. Previous studies have established a framework to test the homogeneity of multiple ATSs by a global Wald test through inverse probability weighting. SMARTs are generally lengthier than classical clinical trials due to the sequential nature of treatment randomization in multiple stages. Thus, it would be beneficial to add interim analyses allowing for early stop if overwhelming efficacy is observed. We introduce group sequential methods to SMARTs to fa…
In this paper we consider a group sequentially monitored trial on a survival endpoint, monitored using a weighted log-rank (WLR) statistic with deterministic weight function. We introduce a summary statistic in the form of a weighted average logged relative risk and show that if there is no sign change in the instantaneous logged relative risk, there always exists a bijection between the WLR statistic and the weighted average logged relative risk. We show that this bijection can be consistently estimated at each analysis under a suitable shape assumption, for which we have listed two possibili…
In covariate-adaptive or response-adaptive randomization, the treatment assignment and outcome can be correlated. Under this situation, re-randomization tests are a straightforward and attractive method to provide valid statistical inference. In this paper, we investigate the number of repetitions in the re-randomization tests. This is motivated by the group sequential design in clinical trials, where the nominal significance bound can be very small at an interim analysis. Accordingly, re-randomization tests lead to a very large number of required repetitions, which may be computationally intr…
Recently, methodology was presented to facilitate the incorporation of interim analyses in stepped-wedge (SW) cluster randomised trials (CRTs). Here, we extend this previous discussion. We detail how the stopping boundaries, allocation sequences, and per-cluster per-period sample size of a group sequential SW-CRT can be optimised. We then describe methods by which point estimates, p-values, and confidence intervals, which account for the sequential nature of the design, can be calculated. We demonstrate that optimal sequential designs can reduce the expected required number of measurements und…
When testing multiple hypotheses, a suitable error rate should be controlled even in exploratory trials. Conventional methods to control the False Discovery Rate (FDR) assume that all p-values are available at the time point of test decision. In platform trials, however, treatment arms enter and leave the trial at any time during its conduct. Therefore, the number of treatments and hypothesis tests is not fixed in advance and hypotheses are not tested at once, but sequentially. Recently, for such a setting the concept of online control of the FDR was introduced. We investigate the LOND procedu…
The primary analysis in two-arm clinical trials usually involves inference on a scalar treatment effect parameter; e.g., depending on the outcome, the difference of treatment-specific means, risk difference, risk ratio, or odds ratio. Most clinical trials are monitored for the possibility of early stopping. Because ordinarily the outcome on any given subject can be ascertained only after some time lag, at the time of an interim analysis, among the subjects already enrolled, the outcome is known for only a subset and is effectively censored for those who have not been enrolled sufficiently long…
A two-stage adaptive optimal design is an attractive option for increasing the efficiency of clinical trials. In these designs, based on interim data, the locally optimal dose is chosen for further exploration, which induces dependencies between data from the two stages. When the maximum likelihood estimator (MLE) is used under nonlinear regression models with independent normal errors in a pilot study where the first stage sample size is fixed, and the second stage sample size is large, the Fisher information fails to normalize the estimator adequately asymptotically, because of dependencies.…
Informative interim adaptations lead to random sample sizes. The random sample size becomes a component of the sufficient statistic and estimation based solely on observed samples or on the likelihood function does not use all available statistical evidence. The total Fisher Information (FI) is decomposed into the design FI and a conditional-on-design FI. The FI unspent by the interim adaptation is used to determine the lower mean squared error in post-adaptation estimation. Theoretical results are illustrated with simple normal samples collected according to a two-stage design with a possibil…
Often in Phase 3 clinical trials measuring a long-term time-to-event endpoint, such as overall survival or progression-free survival, investigators also collect repeated measures on biomarkers which may be predictive of the primary endpoint. Although these data may not be leveraged directly to support early stopping decisions, can we make greater use of these data to increase efficiency and improve interim decision making? We present a joint model for longitudinal and time-to-event data and a method which establishes the distribution of successive estimates of parameters in the joint model acr…
When a clinical trial is subject to a series of interim analyses as a result of which the study may be terminated or modified, final frequentist analyses need to take account of the design used. Failure to do so may result in overstated levels of significance, biased effect estimates and confidence intervals with inadequate coverage probabilities. A wide variety of valid methods of frequentist analysis have been devised for sequential designs comparing a single experimental treatment with a single control treatment. It is less clear how to perform the final analysis of a sequential or adaptive…
Clinical trials usually involve sequential patient entry. When designing a clinical trial, it is often desirable to include a provision for interim analyses of accumulating data with the potential for stopping the trial early. We review Bayesian sequential clinical trial designs based on posterior probabilities, posterior predictive probabilities, and decision-theoretic frameworks. A pertinent question is whether Bayesian sequential designs need to be adjusted for the planning of interim analyses. We answer this question from three perspectives: a frequentist-oriented perspective, a calibrated…
Predicting fixed-sample test decisions enables anytime-valid inference
AI & Robotics Institute, Ellison Institute of Technology（艾利森技术学院人工智能与机器人研究所）；Department of Statistics, University of Oxford（牛津大学统计系）；University of Kent（肯特大学）
The aim of sequential change-point detection is to issue an alarm when it is thought that certain probabilistic properties of the monitored observations have changed. This work is concerned with nonparametric, closed-end testing procedures based on differences of empirical distribution functions that are designed to be particularly sensitive to changes in the comtemporary distribution of multivariate time series. The proposed detectors are adaptations of statistics used in a posteriori (offline) change-point testing and involve a weighting allowing to give more importance to recent observation…
Non-proportional hazards (NPH) have been observed recently in many immuno-oncology clinical trials. Weighted log-rank tests (WLRT) with suitably chosen weights can be used to improve the power of detecting the difference of the two survival curves in the presence of NPH. However, it is not easy to choose a proper WLRT in practice when both robustness and efficiency are considered. A versatile maxcombo test was proposed to achieve the balance of robustness and efficiency and has received increasing attentions in both methodology development and application. However, survival trials often warran…
Confirmatory adaptive group sequential designs for clinical trials with multiple time-to-event outcomes in Markov models
Institute of Biostatistics and Clinical Research, University of Münster（明斯特大学生物统计与临床研究研究所）；Department of Pediatric Oncology and Hematology, University Hospital Cologne（科隆大学医院儿科肿瘤与血液科）
In randomized trials, appropriately adjusting for baseline variables and short-term outcomes can lead to increased precision and reduced sample size. We examine the impact of such adjustment in group sequential designs, i.e., designs with preplanned interim analyses where enrollment may be stopped early for efficacy or futility. We address the following questions: how much precision gain can be obtained by appropriately adjusting for baseline variables and a short-term outcome? How is this precision gain impacted by factors such as the proportion of pipeline participants (those who enrolled bu…
The majority of historical designs are a priori in nature, where a priori indicates a design can be specified in advance of the experiment. The conventional wisdom is that the set of a priori designs is sufficient to produce efficient experiments. This work challenges this convention and finds that efficiency requires data dependent strategies. Specifically, in the context of a sequential experiment, where observations are accrued in a series of runs, an adaptive design is proposed that is guaranteed to be more efficient than any corresponding a priori design.
Rapid evaluation and calibration of Bayesian group sequential designs via conjugate-mixture semi-simulation
The George Institute for Global Health, Imperial College London（乔治全球健康研究院，伦敦帝国理工学院）；Imperial Clinical Trials Unit, Imperial College London（伦敦帝国理工学院临床试验中心）；School of Mathematics, University of Bristol（布里斯托大学数学学院）；The George Institute for Global Health, University of New South Wales（乔治全球健康研究院，新南威尔士大学）
