Chowdhury Shrabanti, Tiwari Ram C, Ghosh Samiran
Department of Family Medicine & Public Health Sciences, Wayne State University.
Center of Molecular Medicine and Genetics, Wayne State University.
Stat Biopharm Res. 2019;11(1):34-43. doi: 10.1080/19466315.2018.1554504. Epub 2019 Apr 22.
In this paper we consider three-arm non-inferiority (NI) trial that includes an experimental, a reference, and a placebo arm. While for binary outcomes the risk difference (RD) is the most common and well explored functional form for testing efficacy (or effectiveness), recent FDA guideline suggested other measures such as relative risk (RR) and odds ratio (OR) on the basis of which NI of an experimental treatment can be claimed. However, developing test based on these different functions of binary outcomes are challenging since the construction and interpretation of NI margin for such functions are not trivial extensions of RD based approach. Recently, we have proposed Frequentist approaches for testing NI for these functionals. In this article we further develop Bayesian approaches for testing NI based on effect retention approach for RR and OR. Bayesian paradigm provides a natural path to integrate historical trials' information, as well as it allows the usage of patients'/clinicians' opinions as prior information via sequential learning. In addition we discuss, in detail, the sample size/power calculation which could be readily used while designing such trials in practice.
在本文中,我们考虑了一个三臂非劣效性(NI)试验,该试验包括一个试验组、一个参照组和一个安慰剂组。对于二元结局,风险差(RD)是检验疗效(或有效性)时最常用且研究充分的函数形式,然而,美国食品药品监督管理局(FDA)最近的指南建议采用其他指标,如相对风险(RR)和比值比(OR),据此可以宣称试验治疗的非劣效性。然而,基于二元结局的这些不同函数开发检验方法具有挑战性,因为此类函数的非劣效性界值的构建和解释并非基于风险差方法的简单扩展。最近,我们提出了用于检验这些函数的非劣效性的频率学派方法。在本文中,我们进一步基于RR和OR的效应保留方法开发了用于检验非劣效性的贝叶斯方法。贝叶斯范式为整合历史试验信息提供了一条自然途径,并且它允许通过序贯学习将患者/临床医生的意见用作先验信息。此外,我们详细讨论了在实际设计此类试验时可直接使用的样本量/检验效能计算方法。