Karl E. Peace papers

This collection consists of the personal and research papers of Karl E. Peace, Professor of Biostatistics at Georgia Southern University and namesake of the Karl E. Peace Center for Biostatistics and Survey Research. Materials span 1941to 2018 and include, correspondence, teaching materials, published articles, and manuscripts. A small portion of 3 photographs and artists renderings are also included. This collection is still undergoing processing. Find this collection in the University Libraries\u27 catalog.https://digitalcommons.georgiasouthern.edu/finding-aids/1100/thumbnail.jp

Considerations for Master Protocols Using External Controls

There has been an increasing use of master protocols in oncology clinical trials because of its efficiency and flexibility to accelerate cancer drug development. Depending on the study objective and design, a master protocol trial can be a basket trial, an umbrella trial, a platform trial, or any other form of trials in which multiple drugs and/or multiple subpopulations are studied in parallel under a single protocol. External data and evidence (EDE) can be used in the design and analysis of master protocols such as external controls for treatment effect estimation, which can further improve efficiency of the master protocol trial. This paper provides an overview of different types of external controls and their unique features when used in master protocols. Some key considerations in master protocols with external controls are discussed including construction of estimands and assessment of fit-for-use real-world data. A targeted learning-based causal roadmap is presented which constitutes three key steps: (1) define a target statistical estimand that aligns with the causal estimand for the study objective, (2) use an efficient estimator to estimate the target statistical estimand and its uncertainty, and (3) evaluate the impact of causal assumptions on the study conclusion by performing a sensitivity analysis. Two illustrative examples are provided for master protocols using external controls

Survival Analysis: An Exact Method for Rare Events

Conventional asymptotic methods for survival analysis work well when sample sizes are at least moderately sufficient. When dealing with small sample sizes or rare events, the results from these methods have the potential to be inaccurate or misleading. To handle such data, an exact method is proposed and compared against two other methods: 1) the Cox proportional hazards model and 2) stratified logistic regression for discrete survival analysis data

Marginal structural cox models with case-cohort sampling

A common objective of biomedical cohort studies is assessing the effect of a time-varying treatment or exposure on a survival time. In the presence of time-varying confounders, marginal structural models fit using inverse probability weighting can be employed to obtain a consistent and asymptotically normal estimator of the causal effect of a time-varying treatment. This article considers estimation of parameters in the semiparametric marginal structural Cox model (MSCM) from a case-cohort study. Case-cohort sampling entails assembling covariate histories only for cases and a random subcohort, which can be cost effective, particularly in large cohort studies with low outcome rates. Following Cole et al. (2012), we consider estimating the causal hazard ratio from a MSCM by maximizing a weighted-pseudo-partial-likelihood. The estimator is shown to be consistent and asymptotically normal under certain regularity conditions. Finite sample performance of the proposed estimator is evaluated in a simulation study. In the corresponding supplementary document, computation of the estimator using standard survival analysis software is presented

Clinicogenomic factors of biotherapy immunogenicity in autoimmune disease: A prospective multicohort study of the ABIRISK consortium

BACKGROUND: Biopharmaceutical products (BPs) are widely used to treat autoimmune diseases, but immunogenicity limits their efficacy for an important proportion of patients. Our knowledge of patient-related factors influencing the occurrence of antidrug antibodies (ADAs) is still limited. METHODS AND FINDINGS: The European consortium ABIRISK (Anti-Biopharmaceutical Immunization: prediction and analysis of clinical relevance to minimize the RISK) conducted a clinical and genomic multicohort prospective study of 560 patients with multiple sclerosis (MS, n = 147), rheumatoid arthritis (RA, n = 229), Crohn's disease (n = 148), or ulcerative colitis (n = 36) treated with 8 different biopharmaceuticals (etanercept, n = 84; infliximab, n = 101; adalimumab, n = 153; interferon [IFN]-beta-1a intramuscularly [IM], n = 38; IFN-beta-1a subcutaneously [SC], n = 68; IFN-beta-1b SC, n = 41; rituximab, n = 31; tocilizumab, n = 44) and followed during the first 12 months of therapy for time to ADA development. From the bioclinical data collected, we explored the relationships between patient-related factors and the occurrence of ADAs. Both baseline and time-dependent factors such as concomitant medications were analyzed using Cox proportional hazard regression models. Mean age and disease duration were 35.1 and 0.85 years, respectively, for MS; 54.2 and 3.17 years for RA; and 36.9 and 3.69 years for inflammatory bowel diseases (IBDs). In a multivariate Cox regression model including each of the clinical and genetic factors mentioned hereafter, among the clinical factors, immunosuppressants (adjusted hazard ratio [aHR] = 0.408 [95% confidence interval (CI) 0.253-0.657], p < 0.001) and antibiotics (aHR = 0.121 [0.0437-0.333], p < 0.0001) were independently negatively associated with time to ADA development, whereas infections during the study (aHR = 2.757 [1.616-4.704], p < 0.001) and tobacco smoking (aHR = 2.150 [1.319-3.503], p < 0.01) were positively associated. 351,824 Single-Nucleotide Polymorphisms (SNPs) and 38 imputed Human Leukocyte Antigen (HLA) alleles were analyzed through a genome-wide association study. We found that the HLA-DQA1*05 allele significantly increased the rate of immunogenicity (aHR = 3.9 [1.923-5.976], p < 0.0001 for the homozygotes). Among the 6 genetic variants selected at a 20% false discovery rate (FDR) threshold, the minor allele of rs10508884, which is situated in an intron of the CXCL12 gene, increased the rate of immunogenicity (aHR = 3.804 [2.139-6.764], p < 1 × 10-5 for patients homozygous for the minor allele) and was chosen for validation through a CXCL12 protein enzyme-linked immunosorbent assay (ELISA) on patient serum at baseline before therapy start. CXCL12 protein levels were higher for patients homozygous for the minor allele carrying higher ADA risk (mean: 2,693 pg/ml) than for the other genotypes (mean: 2,317 pg/ml; p = 0.014), and patients with CXCL12 levels above the median in serum were more prone to develop ADAs (aHR = 2.329 [1.106-4.90], p = 0.026). A limitation of the study is the lack of replication; therefore, other studies are required to confirm our findings. CONCLUSION: In our study, we found that immunosuppressants and antibiotics were associated with decreased risk of ADA development, whereas tobacco smoking and infections during the study were associated with increased risk. We found that the HLA-DQA1*05 allele was associated with an increased rate of immunogenicity. Moreover, our results suggest a relationship between CXCL12 production and ADA development independent of the disease, which is consistent with its known function in affinity maturation of antibodies and plasma cell survival. Our findings may help physicians in the management of patients receiving biotherapies

Bayesian design of superiority clinical trials for recurrent events data with applications to bleeding and transfusion events in myelodyplastic syndrome: Bayesian Design of Superiority Clinical Trials for Recurrent Events Data with Applications

In many biomedical studies, patients may experience the same type of recurrent event repeatedly over time, such as bleeding, multiple infections and disease. In this article, we propose a Bayesian design to a pivotal clinical trial in which lower risk myelodysplastic syndromes (MDS) patients are treated with MDS disease modifying therapies. One of the key study objectives is to demonstrate the investigational product (treatment) effect on reduction of platelet transfusion and bleeding events while receiving MDS therapies. In this context, we propose a new Bayesian approach for the design of superiority clinical trials using recurrent events frailty regression models. Historical recurrent events data from an already completed phase 2 trial are incorporated into the Bayesian design via the partial borrowing power prior of Ibrahim et al. (2012, Biometrics 68, 578–586). An efficient Gibbs sampling algorithm, a predictive data generation algorithm, and a simulation-based algorithm are developed for sampling from the fitting posterior distribution, generating the predictive recurrent events data, and computing various design quantities such as the type I error rate and power, respectively. An extensive simulation study is conducted to compare the proposed method to the existing frequentist methods and to investigate various operating characteristics of the proposed design

Joint modeling of bivariate time to event data with semi-competing risk

Indiana University-Purdue University Indianapolis (IUPUI)Survival analysis often encounters the situations of correlated multiple events including the same type of event observed from siblings or multiple events experienced by the same individual. In this dissertation, we focus on the joint modeling of bivariate time to event data with the estimation of the association parameters and also in the situation of a semi-competing risk. This dissertation contains three related topics on bivariate time to event mod els. The first topic is on estimating the cross ratio which is an association parameter between bivariate survival functions. One advantage of using cross-ratio as a depen dence measure is that it has an attractive hazard ratio interpretation by comparing two groups of interest. We compare the parametric, a two-stage semiparametric and a nonparametric approaches in simulation studies to evaluate the estimation perfor mance among the three estimation approaches. The second part is on semiparametric models of univariate time to event with a semi-competing risk. The third part is on semiparametric models of bivariate time to event with semi-competing risks. A frailty-based model framework was used to accommodate potential correlations among the multiple event times. We propose two estimation approaches. The first approach is a two stage semiparametric method where cumulative baseline hazards were estimated by nonparametric methods first and used in the likelihood function. The second approach is a penalized partial likelihood approach. Simulation studies were conducted to compare the estimation accuracy between the proposed approaches. Data from an elderly cohort were used to examine factors associated with times to multiple diseases and considering death as a semi-competing risk

Treatment Comparison in Biomedical Studies Using Survival Function

In the dissertation, we study the statistical evaluation of treatment comparisons by evaluating the relative comparison of survival experiences between two treatment groups. We construct confidence interval and simultaneous confidence bands for the ratio and odds ratio of two survival functions through both parametric and nonparametric approaches.We first construct empirical likelihood confidence interval and simultaneous confidence bands for the odds ratio of two survival functions to address small sample efficacy and sufficiency. The empirical log-likelihood ratio is developed, and the corresponding asymptotic distribution is derived. Simulation studies show that the proposed empirical likelihood band has outperformed the normal approximation band in small sample size cases in the sense that it yields closer coverage probabilities to chosen nominal levels.Furthermore, in order to incorporate prognostic factors for the adjustment of survival functions in the comparison, we construct simultaneous confidence bands for the ratio and odds ratio of survival functions based on both the Cox model and the additive risk model. We develop simultaneous confidence bands by approximating the limiting distribution of cumulative hazard functions by zero-mean Gaussian processes whose distributions can be generated through Monte Carlo simulations. Simulation studies are conducted to evaluate the performance for proposed models. Real applications on published clinical trial data sets are also studied for further illustration purposes.In the end, the population attributable fraction function is studied to measure the impact of risk factors on disease incidence in the population. We develop semiparametric estimation of attributable fraction functions for cohort studies with potentially censored event time under the additive risk model