McEvoy Bradley W, Nandy Rajesh R, Tiwari Ram C
Office of Biostatistics, CDER, FDA, 10903 New Hampshire Ave, Silver Spring, Marryland 20993, U.S.A.
Biometrics. 2013 Sep;69(3):661-72. doi: 10.1111/biom.12051. Epub 2013 Jul 11.
In drug safety, development of statistical methods for multiplicity adjustments has exploited potential relationships among adverse events (AEs) according to underlying medical features. Due to the coarseness of the biological features used to group AEs together, which serves as the basis for the adjustment, it is possible that a single adverse event can be simultaneously described by multiple biological features. However, existing methods are limited in that they are not structurally flexible enough to accurately exploit this multi-dimensional characteristic of an adverse event. In order to preserve the complex dependencies present in clinical safety data, a Bayesian approach for modeling the risk differentials of the AEs between the treatment and comparator arms is proposed which provides a more appropriate clinical description of the drug's safety profile. The proposed procedure uses an Ising prior to unite medically related AEs. The proposed method and an existing Bayesian method are applied to a clinical dataset, and the signals from the two methods are presented. Results from a small simulation study are also presented.
在药物安全性方面,用于多重性调整的统计方法的发展已根据潜在医学特征利用了不良事件(AE)之间的潜在关系。由于用于将不良事件归为一组的生物学特征较为粗略,而这是调整的基础,所以单个不良事件有可能同时由多种生物学特征来描述。然而,现有方法存在局限性,即其结构灵活性不足,无法准确利用不良事件的这种多维度特征。为了保留临床安全性数据中存在的复杂相关性,提出了一种用于对治疗组和对照臂之间不良事件的风险差异进行建模的贝叶斯方法,该方法能对药物的安全性概况提供更合适的临床描述。所提出的程序使用伊辛先验来合并医学相关的不良事件。将所提出的方法和一种现有的贝叶斯方法应用于一个临床数据集,并展示了两种方法的信号。还展示了一个小型模拟研究的结果。