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Main Authors: Deng, Yuhao, Han, Shasha, Zhou, Xiao-Hua
Format: Preprint
Published: 2024
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Online Access:https://arxiv.org/abs/2401.14684
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author Deng, Yuhao
Han, Shasha
Zhou, Xiao-Hua
author_facet Deng, Yuhao
Han, Shasha
Zhou, Xiao-Hua
contents In randomized controlled trials (RCTs) that focus on time-to-event outcomes, intercurrent events can arise in two ways: as semi-competing events, which modify the hazard of the primary outcome events, or as competing events, which make the definition of the primary outcome events unclear. Although five strategies have been proposed in the ICH E9 (R1) addendum to address intercurrent events in RCTs, these strategies are not easily applicable to time-to-event outcomes when aiming for causal interpretations. In this study, we show how to define, estimate, and make inferences concerning objectives that have causal interpretations within these contexts. Specifically, we derive the mathematical formulations of the causal estimands corresponding to the five strategies and clarify the data structure needed to identify these causal estimands. Furthermore, we introduce nonparametric methods for estimating and making inferences about these causal estimands, including the asymptotic variance of estimators and hypothesis tests. Finally, we illustrate our methods using data from the LEADER Trial, which aims to investigate the effect of liraglutide on cardiovascular outcomes.
format Preprint
id arxiv_https___arxiv_org_abs_2401_14684
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle Inference for Cumulative Incidences and Treatment Effects in Randomized Controlled Trials with Time-to-Event Outcomes under ICH E9 (R1)
Deng, Yuhao
Han, Shasha
Zhou, Xiao-Hua
Methodology
In randomized controlled trials (RCTs) that focus on time-to-event outcomes, intercurrent events can arise in two ways: as semi-competing events, which modify the hazard of the primary outcome events, or as competing events, which make the definition of the primary outcome events unclear. Although five strategies have been proposed in the ICH E9 (R1) addendum to address intercurrent events in RCTs, these strategies are not easily applicable to time-to-event outcomes when aiming for causal interpretations. In this study, we show how to define, estimate, and make inferences concerning objectives that have causal interpretations within these contexts. Specifically, we derive the mathematical formulations of the causal estimands corresponding to the five strategies and clarify the data structure needed to identify these causal estimands. Furthermore, we introduce nonparametric methods for estimating and making inferences about these causal estimands, including the asymptotic variance of estimators and hypothesis tests. Finally, we illustrate our methods using data from the LEADER Trial, which aims to investigate the effect of liraglutide on cardiovascular outcomes.
title Inference for Cumulative Incidences and Treatment Effects in Randomized Controlled Trials with Time-to-Event Outcomes under ICH E9 (R1)
topic Methodology
url https://arxiv.org/abs/2401.14684