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用于相关生存终点的条件连接函数模型:随机对照试验的个体患者数据荟萃分析。

Conditional copula models for correlated survival endpoints: Individual patient data meta-analysis of randomized controlled trials.

作者信息

Emura Takeshi, Sofeu Casimir Ledoux, Rondeau Virginie

机构信息

Biostatistics Center, 12904Kurume University, Japan.

INSERM U1219 (Biostatistic), Université Bordeaux Segalen, France.

出版信息

Stat Methods Med Res. 2021 Dec;30(12):2634-2650. doi: 10.1177/09622802211046390. Epub 2021 Oct 9.

Abstract

Correlations among survival endpoints are important for exploring of the true endpoint. With a valid surrogate endpoint tightly correlated with the true endpoint, the efficacy of a new drug/treatment can be measurable on it. However, the existing methods for measuring correlation between two endpoints impose an invalid assumption: correlation structure is constant across different treatment arms. In this article, we reconsider the definition of Kendall's concordance measure (tau) in the context of individual patient data meta-analyses of randomized controlled trials. According to our new definition of Kendall's tau, its value depends on the treatment arms. We then suggest extending the existing copula (and frailty) models so that their Kendall's tau can vary across treatment arms. Our newly proposed model, a , is the implementation of the new definition of Kendall's tau in meta-analyses. In order to facilitate our approach, we develop an original R function and make it available in the R package (https://CRAN.R-project.org/package=joint.Cox). We apply the proposed method to a gastric cancer dataset (3288 patients in 14 randomized trials from the GASTRIC group). This data analysis concludes that Kendall's tau has different values between the surgical treatment arm and the adjuvant chemotherapy arm (-value<0.001), whereas disease-free survival remains a valid surrogate at individual level for overall survival in these trials.

摘要

生存终点之间的相关性对于探索真正的终点很重要。如果有一个与真正终点紧密相关的有效替代终点,那么新药/治疗方法的疗效就可以在该替代终点上进行衡量。然而,现有的测量两个终点之间相关性的方法存在一个无效假设:不同治疗组的相关结构是恒定的。在本文中,我们在随机对照试验的个体患者数据荟萃分析的背景下重新考虑肯德尔一致性度量(tau)的定义。根据我们对肯德尔tau的新定义,其值取决于治疗组。然后,我们建议扩展现有的 copula(和脆弱性)模型,使它们的肯德尔tau能够在不同治疗组之间变化。我们新提出的模型 a 是肯德尔tau新定义在荟萃分析中的实现。为了便于我们的方法实施,我们开发了一个原创的R函数,并将其提供在R包(https://CRAN.R-project.org/package=joint.Cox)中。我们将所提出的方法应用于一个胃癌数据集(来自GASTRIC组的14项随机试验中的3288名患者)。该数据分析得出结论,手术治疗组和辅助化疗组之间的肯德尔tau值不同(p值<0.001),而在这些试验中,无病生存仍然是个体水平上总生存的有效替代指标。

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