MRC Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
Stat Med. 2023 Jun 30;42(14):2475-2495. doi: 10.1002/sim.9733. Epub 2023 Apr 2.
Platform trials evaluate multiple experimental treatments under a single master protocol, where new treatment arms are added to the trial over time. Given the multiple treatment comparisons, there is the potential for inflation of the overall type I error rate, which is complicated by the fact that the hypotheses are tested at different times and are not necessarily pre-specified. Online error rate control methodology provides a possible solution to the problem of multiplicity for platform trials where a relatively large number of hypotheses are expected to be tested over time. In the online multiple hypothesis testing framework, hypotheses are tested one-by-one over time, where at each time-step an analyst decides whether to reject the current null hypothesis without knowledge of future tests but based solely on past decisions. Methodology has recently been developed for online control of the false discovery rate as well as the familywise error rate (FWER). In this article, we describe how to apply online error rate control to the platform trial setting, present extensive simulation results, and give some recommendations for the use of this new methodology in practice. We show that the algorithms for online error rate control can have a substantially lower FWER than uncorrected testing, while still achieving noticeable gains in power when compared with the use of a Bonferroni correction. We also illustrate how online error rate control would have impacted a currently ongoing platform trial.
平台试验在一个单一的主协议下评估多种实验性治疗方法,随着时间的推移,新的治疗组会被加入到试验中。由于存在多种治疗比较,因此存在整体Ⅰ型错误率膨胀的可能性,这使得假设在不同时间进行测试,并且不一定预先指定这一事实变得复杂。在线误差率控制方法为平台试验的多重性问题提供了一种可能的解决方案,因为预计随着时间的推移会对大量假设进行测试。在在线多重假设检验框架中,随着时间的推移,逐个检验假设,在每个时间点,分析人员根据过去的决策,而不了解未来的测试,决定是否拒绝当前的零假设。最近已经为在线控制假发现率(FDR)和全基因组错误率(FWER)开发了方法。在本文中,我们描述了如何将在线误差率控制应用于平台试验设置,展示了广泛的模拟结果,并为该新方法在实践中的使用提出了一些建议。我们表明,在线误差率控制算法可以比未校正的测试具有更低的 FWER,同时与使用 Bonferroni 校正相比,仍然可以获得显著的功效增益。我们还说明了在线误差率控制将如何影响当前正在进行的平台试验。