Shen Changyu, Li Xiaochun, Jeong Jaesik
a Department of Biostatistics , School of Medicine, Fairbanks School of Public Health, Indiana University , Indianapolis , Indiana , USA.
b Department of Statistics , Chonnam National University , Gwangju , Korea.
J Biopharm Stat. 2016;26(3):507-18. doi: 10.1080/10543406.2015.1052480. Epub 2015 May 26.
It is well recognized that the benefit of a medical intervention may not be distributed evenly in the target population due to patient heterogeneity, and conclusions based on conventional randomized clinical trials may not apply to every person. Given the increasing cost of randomized trials and difficulties in recruiting patients, there is a strong need to develop analytical approaches to estimate treatment effect in subpopulations. In particular, due to limited sample size for subpopulations and the need for multiple comparisons, standard analysis tends to yield wide confidence intervals of the treatment effect that are often noninformative. We propose an empirical Bayes approach to combine both information embedded in a target subpopulation and information from other subjects to construct confidence intervals of the treatment effect. The method is appealing in its simplicity and tangibility in characterizing the uncertainty about the true treatment effect. Simulation studies and a real data analysis are presented.
众所周知,由于患者的异质性,医学干预的益处可能不会在目标人群中均匀分布,基于传统随机临床试验得出的结论可能并不适用于每个人。鉴于随机试验成本不断增加以及招募患者存在困难,迫切需要开发分析方法来估计亚组人群中的治疗效果。特别是,由于亚组人群的样本量有限以及需要进行多重比较,标准分析往往会得出治疗效果的宽泛置信区间,这些区间通常没有实际意义。我们提出一种经验贝叶斯方法,将目标亚组中蕴含的信息与其他受试者的信息相结合,以构建治疗效果的置信区间。该方法在表征真实治疗效果的不确定性方面具有简单性和直观性,颇具吸引力。本文展示了模拟研究和实际数据分析。