Maximin optimal cluster randomized designs for assessing treatment effect heterogeneity

Cluster randomized trials (CRTs) are studies where treatment is randomized at the cluster level but outcomes are typically collected at the individual level. When CRTs are employed in pragmatic settings, baseline population characteristics may moderate treatment effects, leading to what is known as heterogeneous treatment effects (HTEs). Pre-specified, hypothesis-driven HTE analyses in CRTs can enable an understanding of how interventions may impact subpopulation outcomes. While closed-form sample size formulas have recently been proposed, assuming known intracluster correlation coefficients (ICCs) for both the covariate and outcome, guidance on optimal cluster randomized designs to ensure maximum power with pre-specified HTE analyses has not yet been developed. We derive new design formulas to determine the cluster size and number of clusters to achieve the locally optimal design (LOD) that minimizes variance for estimating the HTE parameter given a budget constraint. Given the LODs are based on covariate and outcome-ICC values that are usually unknown, we further develop the maximin design for assessing HTE, identifying the combination of design resources that maximize the relative efficiency of the HTE analysis in the worst case scenario. In addition, given the analysis of the average treatment effect is often of primary interest, we also establish optimal designs to accommodate multiple objectives by combining considerations for studying both the average and heterogeneous treatment effects. We illustrate our methods using the context of the Kerala Diabetes Prevention Program CRT, and provide an R Shiny app to facilitate calculation of optimal designs under a wide range of design parameters.Comment: 25 pages, 6 figures, 5 tables, 3 appendices; clarified phrasing, typos correcte

The effect of heterogeneous variance on efficiency and power of cluster randomized trials with a balanced 2x2 factorial design

Sample size calculation for cluster randomized trials (CRTs) with a 2x2 factorial design is complicated due to the combination of nesting (of individuals within clusters) with crossing (of two treatments). Typically, clusters and individuals are allocated across treatment conditions in a balanced fashion, which is optimal under homogeneity of variance. However, the variance is likely to be heterogeneous if there is a treatment effect. An unbalanced allocation is then more efficient, but impractical because the optimal allocation depends on the unknown variances. Focusing on CRTs with a 2x2 design, this paper addresses two questions: How much efficiency is lost by having a balanced design when the outcome variance is heterogeneous? How large must the sample size be for a balanced allocation to have sufficient power under heterogeneity of variance? We consider different scenarios of heterogeneous variance. Within each scenario, we determine the relative efficiency of a balanced design, as a function of the level (cluster, individual, both) and amount of heterogeneity of the variance. We then provide a simple correction of the sample size for the loss of power due to heterogeneity of variance when a balanced allocation is used. The theory is illustrated with an example of a published 2x2 CRT

Sample size calculations for cluster randomised trials, with a focus on ordinal outcomes.

PhDBackground A common approach to sample size calculation for cluster randomised trials (CRTs) is to calculate the sample size assuming individual randomisation and multiply it by an inflation factor, the design effect. This approach is well established for binary and continuous outcomes, but less so for ordinal. As the variety in trial design increases alternative or more complex methods are required. There is currently no single resource that provides a comprehensive summary of methods. This thesis aims to provide a unique contribution towards the review and development of sample size methods for CRTs, with a focus on ordinal outcomes. Methods I provide a comprehensive review of sample size methods for CRTs and summarise the methodological gaps that remain. Through simulation I evaluate the power performance, under realistic trial scenarios, of the design effect for ordinal outcomes calculated using a kappa-type intracluster correlation coefficient (ICC), the ICC on an assumed underlying variable and an ANOVA ICC. I provide practical guidance for sample size calculation for ordinal outcomes in CRTs. Results Simulation results showed when the number of clusters was large the ANOVA and kappa-type estimates were equivalent, and smaller than the latent variable ICC. Use of the ANOVA ICC in the design effect produced adequately powered trials and power was marginally reduced under a minor deviation from the common assumption of proportional odds used in ordered regression. Conclusions For outcomes with three to five categories the ANOVA ICC, calculated by assigning numerical equally spaced scores to the ordinal categories, can be used in the simple design effect to produce an adequately powered trial. The method assumes an analysis by random effects ordered regression with proportional odds, a reasonable number of clusters, and clusters of the same size.Medical Research Counci

Generalised Linear Mixed Model Specification, Analysis, Fitting, and Optimal Design in R with the glmmr Packages

We describe the \proglang{R} package \pkg{glmmrBase} and an extension \pkg{glmmrOptim}. \pkg{glmmrBase} provides a flexible approach to specifying, fitting, and analysing generalised linear mixed models. We use an object-orientated class system within \proglang{R} to provide methods for a wide range of covariance and mean functions, including specification of non-linear functions of data and parameters, relevant to multiple applications including cluster randomised trials, cohort studies, spatial and spatio-temporal modelling, and split-plot designs. The class generates relevant matrices and statistics and a wide range of methods including full likelihood estimation of generalised linear mixed models using Markov Chain Monte Carlo Maximum Likelihood, Laplace approximation, power calculation, and access to relevant calculations. The class also includes Hamiltonian Monte Carlo simulation of random effects, sparse matrix methods, and other functionality to support efficient estimation. The \pkg{glmmrOptim} package implements a set of algorithms to identify c-optimal experimental designs where observations are correlated and can be specified using the generalised linear mixed model classes. Several examples and comparisons to existing packages are provided to illustrate use of the packages

Timely and reliable evaluation of the effects of interventions: a framework for adaptive meta-analysis (FAME)

Most systematic reviews are retrospective and use aggregate data AD) from publications, meaning they can be unreliable, lag behind therapeutic developments and fail to influence ongoing or new trials. Commonly, the potential influence of unpublished or ongoing trials is overlooked when interpreting results, or determining the value of updating the meta-analysis or need to collect individual participant data (IPD). Therefore, we developed a Framework for Adaptive Metaanalysis (FAME) to determine prospectively the earliest opportunity for reliable AD meta-analysis. We illustrate FAME using two systematic reviews in men with metastatic (M1) and non-metastatic (M0)hormone-sensitive prostate cancer (HSPC)

Book of Abstracts XVIII Congreso de Biometría CEBMADRID

Abstracts of the XVIII Congreso de Biometría CEBMADRID held from 25 to 27 May in MadridInteractive modelling and prediction of patient evolution via multistate models / Leire Garmendia Bergés, Jordi Cortés Martínez and Guadalupe Gómez Melis : This research was funded by the Ministerio de Ciencia e Innovación (Spain) [PID2019104830RBI00]; and the Generalitat de Catalunya (Spain) [2017SGR622 and 2020PANDE00148].Operating characteristics of a model-based approach to incorporate non-concurrent controls in platform trials / Pavla Krotka, Martin Posch, Marta Bofill Roig : EU-PEARL (EU Patient-cEntric clinicAl tRial pLatforms) project has received funding from the Innovative Medicines Initiative (IMI) 2 Joint Undertaking (JU) under grant agreement No 853966. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA and Children’s Tumor Foundation, Global Alliance for TB Drug Development non-profit organisation, Spring works Therapeutics Inc.Modeling COPD hospitalizations using variable domain functional regression / Pavel Hernández Amaro, María Durbán Reguera, María del Carmen Aguilera Morillo, Cristobal Esteban Gonzalez, Inma Arostegui : This work is supported by the grant ID2019-104901RB-I00 from the Spanish Ministry of Science, Innovation and Universities MCIN/AEI/10.13039/501100011033.Spatio-temporal quantile autoregression for detecting changes in daily temperature in northeastern Spain / Jorge Castillo-Mateo, Alan E. Gelfand, Jesús Asín, Ana C. Cebrián / Spatio-temporal quantile autoregression for detecting changes in daily temperature in northeastern Spain : This work was partially supported by the Ministerio de Ciencia e Innovación under Grant PID2020-116873GB-I00; Gobierno de Aragón under Research Group E46_20R: Modelos Estocásticos; and JC-M was supported by Gobierno de Aragón under Doctoral Scholarship ORDEN CUS/581/2020.Estimation of the area under the ROC curve with complex survey data / Amaia Iparragirre, Irantzu Barrio, Inmaculada Arostegui : This work was financially supported in part by IT1294-19, PID2020-115882RB-I00, KK-2020/00049. The work of AI was supported by PIF18/213.INLAMSM: Adjusting multivariate lattice models with R and INLA / Francisco Palmí Perales, Virgilio Gómez Rubio and Miguel Ángel Martínez Beneito : This work has been supported by grants PPIC-2014-001-P and SBPLY/17/180501/000491, funded by Consejería de Educación, Cultura y Deportes (Junta de Comunidades de Castilla-La Mancha, Spain) and FEDER, grant MTM2016-77501-P, funded by Ministerio de Economía y Competitividad (Spain), grant PID2019-106341GB-I00 from Ministerio de Ciencia e Innovación (Spain) and a grant to support research groups by the University of Castilla-La Mancha (Spain). F. Palmí-Perales has been supported by a Ph.D. scholarship awarded by the University of Castilla-La Mancha (Spain)

Seventh International Workshop on Simulation, 21-25 May, 2013, Department of Statistical Sciences, Unit of Rimini, University of Bologna, Italy. Book of Abstracts

Seventh International Workshop on Simulation, 21-25 May, 2013, Department of Statistical Sciences, Unit of Rimini, University of Bologna, Italy. Book of Abstract