In a cluster-randomized experiment, treatment is assigned to clusters of individual units of interest--households, classrooms, villages, etc.--instead of the units themselves. The number of clusters sampled and the number of units sampled within each cluster is typically restricted by a budget constraint. Previous analysis of cluster randomized experiments under the Neyman-Rubin potential outcomes model of response have assumed a simple random sample of clusters. Estimators of the population average treatment effect (PATE) under this assumption are often either biased or not invariant to location shifts of potential outcomes. We demonstrate that, by sampling clusters with probability proportional to the number of units within a cluster, the Horvitz-Thompson estimator (HT) is invariant to location shifts and unbiasedly estimates PATE. We derive standard errors of HT and discuss how to estimate these standard errors. We also show that results hold for stratified random samples when samples are drawn proportionally to cluster size within each stratum. We demonstrate the efficacy of this sampling scheme using a simulation based on data from an experiment measuring the efficacy of the National Solidarity Programme in Afghanistan.
Some patients benefit from a treatment while others may do so less or do not benefit at all. We have previously developed a two-stage network meta-regression prediction model that synthesized randomized trials and evaluates how treatment effects vary across patient characteristics. In this article, we extended this model to combine different sources of types in different formats: aggregate data (AD) and individual participant data (IPD) from randomized and non-randomized evidence. In the first stage, a prognostic model is developed to predict the baseline risk of the outcome using a large coho…
We consider the conditional randomization test as a way to account for covariate imbalance in randomized experiments. The test accounts for covariate imbalance by comparing the observed test statistic to the null distribution of the test statistic conditional on the observed covariate imbalance. We prove that the conditional randomization test has the correct significance level and introduce original notation to describe covariate balance more formally. Through simulation, we verify that conditional randomization tests behave like more traditional forms of covariate adjustmet but have the adde…
Instrumental variable methods are widely used in medical and social science research to draw causal conclusions when the treatment and outcome are confounded by unmeasured confounding variables. One important feature of such studies is that the instrumental variable is often applied at the cluster level, e.g., hospitals' or physicians' preference for a certain treatment where each hospital or physician naturally defines a cluster. This paper proposes to embed such observational instrumental variable data into a cluster-randomized encouragement experiment using statistical matching. Potential o…
The benefit of dose-exposure-response modeling in the estimation of dose-response relationship and dose optimization: some theoretical and simulation evidence
High confidence inference on the probability an individual benefits from treatment using experimental or observational data with known propensity scores
We propose new, optimal methods for analyzing randomized trials, when it is suspected that treatment effects may differ in two predefined subpopulations. Such sub-populations could be defined by a biomarker or risk factor measured at baseline. The goal is to simultaneously learn which subpopulations benefit from an experimental treatment, while providing strong control of the familywise Type I error rate. We formalize this as a multiple testing problem and show it is computationally infeasible to solve using existing techniques. Our solution involves a novel approach, in which we first transfo…
Clinical trials with a hybrid control arm (a control arm constructed from a combination of randomized patients and real-world data on patients receiving usual care in standard clinical practice) have the potential to decrease the cost of randomized trials while increasing the proportion of trial patients given access to novel therapeutics. However, due to stringent trial inclusion criteria and differences in care and data quality between trials and community practice, trial patients may have systematically different outcomes compared to their real-world counterparts. We propose a new method fo…
With climate change threatening agricultural productivity and global food demand increasing, it is important to better understand which farm management practices will maximize crop yields in various climatic conditions. To assess the effectiveness of agricultural practices, researchers often turn to randomized field experiments, which are reliable for identifying causal effects but are often limited in scope and therefore lack external validity. Recently, researchers have also leveraged large observational datasets from satellites and other sources, which can lead to conclusions biased by conf…
Randomized trials typically estimate average relative treatment effects, but decisions on the benefit of a treatment are possibly better informed by more individualized predictions of the absolute treatment effect. In case of a binary outcome, these predictions of absolute individualized treatment effect require knowledge of the individual's risk without treatment and incorporation of a possibly differential treatment effect (i.e. varying with patient characteristics). In this paper we lay out the causal structure of individualized treatment effect in terms of potential outcomes and describe t…
In many randomized clinical trials of therapeutics for COVID-19, the primary outcome is an ordinal categorical variable, and interest focuses on the odds ratio (active agent vs. control) under the assumption of a proportional odds model. Although at the final analysis the outcome will be determined for all subjects, at an interim analysis, the status of some participants may not yet be determined, e.g., because ascertainment of the outcome may not be possible until some pre-specified follow-up time. Accordingly, the outcome from these subjects can be viewed as censored. A valid interim analysi…
Most statistical tests for treatment effects used in randomized clinical trials with survival outcomes are based on the proportional hazards assumption, which often fails in practice. Data from early exploratory studies may provide evidence of non-proportional hazards which can guide the choice of alternative tests in the design of practice-changing confirmatory trials. We study a test to detect treatment effects in a late-stage trial which accounts for the deviations from proportional hazards suggested by early-stage data. Conditional on early-stage data, among all tests which control the fre…
This research was motivated by studying anti-drug antibody (ADA) formation and its potential impact on long-term benefit of a biologic treatment in a randomized controlled trial, in which ADA status was not only unobserved in the control arm but also in a subset of patients from the experimental treatment arm. Recent literature considers the principal stratum estimand strategy to estimate treatment effect in groups of patients defined by an intercurrent status, i.e. in groups defined by a post-randomization variable only observed in one arm and potentially associated with the outcome. However,…
Estimating causal effects from randomized experiments is central to clinical research. Reducing the statistical uncertainty in these analyses is an important objective for statisticians. Registries, prior trials, and health records constitute a growing compendium of historical data on patients under standard-of-care that may be exploitable to this end. However, most methods for historical borrowing achieve reductions in variance by sacrificing strict type-I error rate control. Here, we propose a use of historical data that exploits linear covariate adjustment to improve the efficiency of trial…
Analyzing outcomes in long-term cancer survivor studies can be complex. The effects of predictors on the failure process may be difficult to assess over longer periods of time, as the commonly used assumption of proportionality of hazards holding over an extended period is often questionable. In this manuscript, we compare seven different survival models that estimate the hazard rate and the effects of proportional and non-proportional covariates. In particular, we focus on an extension of the the multi-resolution hazard (MRH) estimator, combining a non-proportional hierarchical MRH approach w…
We present a new estimator of the restricted mean survival time in randomized trials where there is right censoring that may depend on treatment and baseline variables. The proposed estimator leverages prognostic baseline variables to obtain equal or better asymptotic precision compared to traditional estimators. Under regularity conditions and random censoring within strata of treatment and baseline variables, the proposed estimator has the following features: (i) it is interpretable under violations of the proportional hazards assumption; (ii) it is consistent and at least as precise as the …
When evaluating the efficacy of social programs and medical treatments using randomized experiments, the estimated overall average causal effect alone is often of limited value and the researchers must investigate when the treatments do and do not work. Indeed, the estimation of treatment effect heterogeneity plays an essential role in (1) selecting the most effective treatment from a large number of available treatments, (2) ascertaining subpopulations for which a treatment is effective or harmful, (3) designing individualized optimal treatment regimes, (4) testing for the existence or lack o…
Time-to-event analysis often relies on prior parametric assumptions, or, if a non-parametric approach is chosen, Cox's model. This is inherently tied to the assumption of proportional hazards, with the analysis potentially invalidated if this assumption is not fulfilled. In addition, most interpretations focus on the hazard ratio, that is often misinterpreted as the relative risk. In this paper, we introduce an alternative to current methodology for assessing a treatment effect in a two-group situation, not relying on the proportional hazards assumption but assuming proportional risks. Precise…
Cluster randomized trials (CRTs) frequently recruit a small number of clusters, therefore necessitating the application of small-sample corrections for valid inference. A recent systematic review indicated that CRTs reporting right-censored, time-to-event outcomes are not uncommon, and that the marginal Cox proportional hazards model is one of the common approaches used for primary analysis. While small-sample corrections have been studied under marginal models with continuous, binary and count outcomes, no prior research has been devoted to the development and evaluation of bias-corrected san…
\noindent Randomized nomination sampling (RNS) is a rank-based sampling technique which has been shown to be effective in several nonparametric studies involving environmental and ecological applications. In this paper, we investigate parametric inference using RNS design for estimating the unknown vector of parameters $\boldsymbolθ$ in the proportional hazard rate and proportional reverse hazard rate models. We examine both maximum likelihood (ML) and method of moments (MM) methods and investigate the relative precision of our proposed RNS-based estimators compared with those based on simple …
Hamiltonian Monte Carlo (HMC) algorithms which combine numerical approximation of Hamiltonian dynamics on finite intervals with stochastic refreshment and Metropolis correction are popular sampling schemes, but it is known that they may suffer from slow convergence in the continuous time limit. A recent paper of Bou-Rabee and Sanz-Serna (Ann. Appl. Prob., 27:2159-2194, 2017) demonstrated that this issue can be addressed by simply randomizing the duration parameter of the Hamiltonian paths. In this article, we use the same idea to enhance the sampling efficiency of a constrained version of HMC,…
In comparative research on time-to-event data for two groups, when two survival curves cross each other, it may be difficult to use the log-rank test and hazard ratio (HR) to properly assess the treatment benefit. Our aim was to identify a method for evaluating the treatment benefits for two groups in the above situation. We quantified treatment benefits based on an intuitive measure called the area between two survival curves (ABS), which is a robust measure of treatment benefits in clinical trials regardless of whether the proportional hazards assumption is violated or two survival curves cr…
One-sample survival tests in the presence of non-proportional hazards in oncology clinical trials
Oncostat, CESP, INSERM U1018（INSERM U1018）；University Paris-Saclay（巴黎萨克雷大学）；Department of Statistics and Acturial Science（统计与精算学系）；University of Hong Kong（香港大学）
Randomized clinical trials are often designed to assess whether a test treatment prolongs survival relative to a control treatment. Increased patient heterogeneity, while desirable for generalizability of results, can weaken the ability of common statistical approaches to detect treatment differences, potentially hampering the regulatory approval of safe and efficacious therapies. A novel solution to this problem is proposed. A list of baseline covariates that have the potential to be prognostic for survival under either treatment is pre-specified in the analysis plan. At the analysis stage, u…
