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arXiv 2209.06306stat.ME
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利用部分信息对序贯多重分配随机试验进行中期监测

Interim Monitoring of Sequential Multiple Assignment Randomized Trials Using Partial Information

Cole Manschot, Eric Laber, Marie Davidian

AI总结:

提出利用部分信息估计SMART中平均结果的估计量,推导提前停止检验程序,在控制I类错误和达到名义功效的同时减少预期样本量。

摘要:

序贯多重分配随机试验(SMART)是生成数据以评估多阶段治疗方案的金标准试验设计。与传统的(单阶段)随机临床试验一样,中期监测允许提前停止;然而,在SMART中很少有用于规范中期分析的方法。由于SMART涉及多个治疗阶段,一个关键挑战是在中期分析时,并非所有入组参与者都已进展通过所有治疗阶段。Wu等人(2021)提出基于给定方案下平均结果的估计量进行中期分析,该估计量仅使用已完成所有治疗阶段的参与者的数据。我们提出了一种给定方案下平均结果的估计量,通过使用入组参与者的部分信息来提高效率,而不论其治疗阶段进展如何。利用该估计量的渐近分布,我们推导了用于提前停止的Pocock和O'Brien-Fleming检验程序。在模拟实验中,该估计量控制了I类错误并达到了名义功效,同时相对于Wu等人(2021)的方法减少了预期样本量。我们基于最近一项评估乳腺癌患者行为疼痛干预的SMART展示了所提估计量的说明性应用。

英文摘要:

The sequential multiple assignment randomized trial (SMART) is the gold standard trial design to generate data for the evaluation of multi-stage treatment regimes. As with conventional (single-stage) randomized clinical trials, interim monitoring allows early stopping; however, there are few methods for principled interim analysis in SMARTs. Because SMARTs involve multiple stages of treatment, a key challenge is that not all enrolled participants will have progressed through all treatment stages at the time of an interim analysis. Wu et al. (2021) propose basing interim analyses on an estimator for the mean outcome under a given regime that uses data only from participants who have completed all treatment stages. We propose an estimator for the mean outcome under a given regime that gains efficiency by using partial information from enrolled participants regardless of their progression through treatment stages. Using the asymptotic distribution of this estimator, we derive associated Pocock and O'Brien-Fleming testing procedures for early stopping. In simulation experiments, the estimator controls type I error and achieves nominal power while reducing expected sample size relative to the method of Wu et al. (2021). We present an illustrative application of the proposed estimator based on a recent SMART evaluating behavioral pain interventions for breast cancer patients.

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

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