Helms Ronald W
Rho, Inc., Chapel Hill, NC, USA.
Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA.
Pharm Stat. 2016 Nov;15(6):471-485. doi: 10.1002/pst.1767. Epub 2016 Sep 13.
Biostatisticians recognize the importance of precise definitions of technical terms in randomized controlled clinical trial (RCCT) protocols, statistical analysis plans, and so on, in part because definitions are a foundation for subsequent actions. Imprecise definitions can be a source of controversies about appropriate statistical methods, interpretation of results, and extrapolations to larger populations. This paper presents precise definitions of some familiar terms and definitions of some new terms, some perhaps controversial. The glossary contains definitions that can be copied into a protocol, statistical analysis plan, or similar document and customized. The definitions were motivated and illustrated in the context of a longitudinal RCCT in which some randomized enrollees are non-adherent, receive a corrupted treatment, or withdraw prematurely. The definitions can be adapted for use in a much wider set of RCCTs. New terms can be used in place of controversial terms, for example, subject. We define terms specifying a person's progress through RCCT phases and that precisely define the RCCT's phases and milestones. We define terms that distinguish between subsets of an RCCT's enrollees and a much larger patient population. 'The intention-to-treat (ITT) principle' has multiple interpretations that can be distilled to the definitions of the 'ITT analysis set of randomized enrollees'. Most differences among interpretations of 'the' ITT principle stem from an RCCT's primary objective (mainly efficacy versus effectiveness). Four different 'authoritative' definitions of ITT analysis set of randomized enrollees illustrate the variety of interpretations. We propose a separate specification of the analysis set of data that will be used in a specific analysis. Copyright © 2016 John Wiley & Sons, Ltd.
生物统计学家认识到在随机对照临床试验(RCCT)方案、统计分析计划等中对技术术语进行精确定义的重要性,部分原因是定义是后续行动的基础。不精确的定义可能成为关于适当统计方法、结果解释以及向更大人群外推的争议来源。本文给出了一些常见术语的精确定义以及一些新术语的定义,其中一些可能存在争议。术语表包含可复制到方案、统计分析计划或类似文档中并进行定制的定义。这些定义是在一项纵向RCCT的背景下提出并举例说明的,在该试验中,一些随机入组的受试者不依从、接受了错误的治疗或过早退出。这些定义可适用于更广泛的RCCT集合。可以使用新术语代替有争议的术语,例如“受试者”。我们定义了指定一个人在RCCT各阶段进展的术语,并精确界定了RCCT的阶段和里程碑。我们定义了区分RCCT入组者子集和更广泛患者群体的术语。“意向性分析(ITT)原则”有多种解释,可提炼为“随机入组者的ITT分析集”的定义。对“ITT原则”解释的大多数差异源于RCCT的主要目标(主要是疗效与效果)。随机入组者的ITT分析集的四种不同“权威”定义说明了解释的多样性。我们提议单独指定将用于特定分析的数据的分析集。版权所有© 2016约翰·威利父子有限公司。