Yuan Chuanji, Yang Zhenyu, Liu Jiaqing, Li Xiaozhou, Chen Bokai, Han Tao, Yu Qian, Li Zuojing
Department of Pharmaceutical informatics, School of Shenyang Pharmaceutical University, Shenyang, 110016, Liaoning, China.
Liaoning Yeedo Medical Data Technology Co., Ltd, Shenyang, 110170, Liaoning, China.
Contemp Clin Trials. 2025 May;152:107886. doi: 10.1016/j.cct.2025.107886. Epub 2025 Mar 20.
The ICH E9 R1 Addendum suggests using a treatment-policy strategy as an approach to handle intercurrent events for estimating de facto estimand. Under this strategy, regardless of the occurrence of intercurrent events, the value for the variable of interest is analyzed. After discontinuing treatment, participants who remain in the trial to complete the assessment of the primary endpoints are referred to as retrieved dropouts, while early withdrawal by participants results in missing data. To mitigate the effects of missing data, strategies like mixed model for repeated measures or the retrieved dropout multiple imputation method are used. The bias of retrieved dropout methods is relatively small. However, if retrieved dropouts are scarce, it could significantly inflate variance. This article introduces an innovative adaptive model that refines the On/Off Intercepts with Common Slopes using Residuals (RD_OICSR) model, which is a model within the retrieved dropout methods, and evaluates it using simulated data from a depression trial. The findings indicate that when the proportion of retrieved dropouts falls below the predetermined threshold set by researchers, our method minimizes unrealistic variance inflation by incorporating data from placebo completers. Conversely, the model adaptively matches the RD_OICSR model. This ensures that irrespective of the retrieved dropouts' proportions, the analysis remains accurate.
《国际人用药品注册技术协调会E9 R1增编》建议采用治疗策略方法来处理并发事件,以估计实际估计量。在该策略下,无论并发事件是否发生,均对感兴趣变量的值进行分析。在停止治疗后,留在试验中完成主要终点评估的参与者被称为找回的失访者,而参与者提前退出会导致数据缺失。为减轻数据缺失的影响,可采用重复测量混合模型或找回的失访者多重填补法等策略。找回的失访者方法的偏差相对较小。然而,如果找回的失访者很少,可能会显著夸大方差。本文介绍了一种创新的自适应模型,即使用残差细化具有共同斜率的开/关截距(RD_OICSR)模型,该模型属于找回的失访者方法中的一种模型,并使用来自一项抑郁症试验的模拟数据对其进行评估。研究结果表明,当找回的失访者比例低于研究人员设定的预定阈值时,我们的方法通过纳入安慰剂完成者的数据,将不切实际的方差膨胀降至最低。相反,该模型会自适应地匹配RD_OICSR模型。这确保了无论找回的失访者比例如何,分析结果都保持准确。