Testing for qualitative heterogeneity: An application to composite endpoints in survival analysis.

Composite endpoints are frequently used in clinical outcome trials to provide more endpoints, thereby increasing statistical power. A key requirement for a composite endpoint to be meaningful is the absence of the so-called qualitative heterogeneity to ensure a valid overall interpretation of any tr...

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Publicado en:Statistical Methods in Medical Research Vol. 28; no. 1; pp. 151 - 170
Autores principales: Oulhaj, Abderrahim, El Ghouch, Anouar, Holman, Rury R.
Formato: equations & formulas research tables/charts Journal Article
Publicado: Sage Publications Inc. Jan2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2019
      vid: 28
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Testing for qualitative heterogeneity: An application to composite endpoints in survival analysis.
      aug:
        au:
          Oulhaj, Abderrahim
          El Ghouch, Anouar
          Holman, Rury R.
        affil: Institute of public health, College of Medicine & Health Sciences, United Arab Emirates University (UAEU), United Arab Emirates
      sug:
        subj:
          Biological Assay Statistics and Numerical Data
          Survival Analysis
          Clinical Trials Methods
          Alzheimer's Disease Drug Therapy
          Sample Size
          Human
          Treatment Outcomes
          Cox Proportional Hazards Model
          Data Analysis, Statistical
          Double-Blind Studies
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Questionnaires
          Scales
      ab: Composite endpoints are frequently used in clinical outcome trials to provide more endpoints, thereby increasing statistical power. A key requirement for a composite endpoint to be meaningful is the absence of the so-called qualitative heterogeneity to ensure a valid overall interpretation of any treatment effect identified. Qualitative heterogeneity occurs when individual components of a composite endpoint exhibit differences in the direction of a treatment effect. In this paper, we develop a general statistical method to test for qualitative heterogeneity, that is to test whether a given set of parameters share the same sign. This method is based on the intersection-union principle and, provided that the sample size is large, is valid whatever the model used for parameters estimation. We propose two versions of our testing procedure, one based on a random sampling from a Gaussian distribution and another version based on bootstrapping. Our work covers both the case of completely observed data and the case where some observations are censored which is an important issue in many clinical trials. We evaluated the size and power of our proposed tests by carrying out some extensive Monte Carlo simulations in the case of multivariate time to event data. The simulations were designed under a variety of conditions on dimensionality, censoring rate, sample size and correlation structure. Our testing procedure showed very good performances in terms of statistical power and type I error. The proposed test was applied to a data set from a single-center, randomized, double-blind controlled trial in the area of Alzheimer's disease.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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