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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Sample size re-estimation for superiority clinical trials with a dichotomous outcome using an unblinded estimate of the control group outcome rate

Bliss, Caleb Andrew 22 January 2016 (has links)
Superiority clinical trials are often designed with a planned interim analysis for the purpose of sample size re-estimation (SSR) when limited information is available at the start of the trial to estimate the required sample size. Typically these trials are designed with a two-arm internal pilot where subjects are enrolled to both treatment arms prior to the interim analysis. Circumstances may sometimes call for a trial with a single-arm internal pilot (enroll only in the control group). For a dichotomous outcome, Herson and Wittes proposed a SSR method (HW-SSR) that can be applied to single-arm internal pilot trials using an unblinded estimate of the control group outcome rate. Previous evaluations of the HW-SSR method reported conflicting results regarding the impact of the method on the two-sided Type I error rate and power of the final hypothesis test. In this research we evaluate the HW-SSR method under the null and alternative hypothesis in various scenarios to investigate the one-sided Type I error rate and power of trials with a two-arm internal pilot. We find that the one-sided Type I error rate is sometimes inflated and that the power is sometimes reduced. We propose a new method, the Critical Value and Power Adjusted Sample Size Re-estimation (CVPA-SSR) algorithm to adjust the critical value cutoff used in the final Z-test and the power critical value used in the interim SSR formula to preserve the nominal Type I error rate and the desired power. We conduct simulations for trials with single-arm and two-arm internal pilots to confirm that the CVPA-SSR algorithm does preserve the nominal Type I error rate and the desired power. We investigate the robustness of the CVPA-SSR algorithm for trials with single-arm and two-arm internal pilots when the assumptions used in designing the trial are incorrect. No Type I error inflation is observed but significant over- or under-powering of the trial occurs when the treatment effect used to design the trial is misspecified.

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