Design and estimation in clinical trials with subpopulation selection.

Abstract:

:Population heterogeneity is frequently observed among patients' treatment responses in clinical trials because of various factors such as clinical background, environmental, and genetic factors. Different subpopulations defined by those baseline factors can lead to differences in the benefit or safety profile of a therapeutic intervention. Ignoring heterogeneity between subpopulations can substantially impact on medical practice. One approach to address heterogeneity necessitates designs and analysis of clinical trials with subpopulation selection. Several types of designs have been proposed for different circumstances. In this work, we discuss a class of designs that allow selection of a predefined subgroup. Using the selection based on the maximum test statistics as the worst-case scenario, we then investigate the precision and accuracy of the maximum likelihood estimator at the end of the study via simulations. We find that the required sample size is chiefly determined by the subgroup prevalence and show in simulations that the maximum likelihood estimator for these designs can be substantially biased.

journal_name

Stat Med

journal_title

Statistics in medicine

authors

Chiu YD,Koenig F,Posch M,Jaki T

doi

10.1002/sim.7925

subject

Has Abstract

pub_date

2018-12-20 00:00:00

pages

4335-4352

issue

29

eissn

0277-6715

issn

1097-0258

journal_volume

37

pub_type

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