Adaptive weight selection for time-to-event data under non-proportional hazards

Fuente: arXiv
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Auteurs principaux: Danzer, Moritz Fabian, Dormuth, Ina
Format: Preprint
Publié: 2024
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author Danzer, Moritz Fabian
Dormuth, Ina
author_facet Danzer, Moritz Fabian
Dormuth, Ina
contents When planning a clinical trial for a time-to-event endpoint, we require an estimated effect size and need to consider the type of effect. Usually, an effect of proportional hazards is assumed with the hazard ratio as the corresponding effect measure. Thus, the standard procedure for survival data is generally based on a single-stage log-rank test. Knowing that the assumption of proportional hazards is often violated and sufficient knowledge to derive reasonable effect sizes is usually unavailable, such an approach is relatively rigid. We introduce a more flexible procedure by combining two methods designed to be more robust in case we have little to no prior knowledge. First, we employ a more flexible adaptive multi-stage design instead of a single-stage design. Second, we apply combination-type tests in the first stage of our suggested procedure to benefit from their robustness under uncertainty about the deviation pattern. We can then use the data collected during this period to choose a more specific single-weighted log-rank test for the subsequent stages. In this step, we employ Royston-Parmar spline models to extrapolate the survival curves to make a reasonable decision. Based on a real-world data example, we show that our approach can save a trial that would otherwise end with an inconclusive result. Additionally, our simulation studies demonstrate a sufficient power performance while maintaining more flexibility.
format Preprint
id arxiv_https___arxiv_org_abs_2409_15145
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle Adaptive weight selection for time-to-event data under non-proportional hazards
Danzer, Moritz Fabian
Dormuth, Ina
Methodology
62N03
G.3.16
When planning a clinical trial for a time-to-event endpoint, we require an estimated effect size and need to consider the type of effect. Usually, an effect of proportional hazards is assumed with the hazard ratio as the corresponding effect measure. Thus, the standard procedure for survival data is generally based on a single-stage log-rank test. Knowing that the assumption of proportional hazards is often violated and sufficient knowledge to derive reasonable effect sizes is usually unavailable, such an approach is relatively rigid. We introduce a more flexible procedure by combining two methods designed to be more robust in case we have little to no prior knowledge. First, we employ a more flexible adaptive multi-stage design instead of a single-stage design. Second, we apply combination-type tests in the first stage of our suggested procedure to benefit from their robustness under uncertainty about the deviation pattern. We can then use the data collected during this period to choose a more specific single-weighted log-rank test for the subsequent stages. In this step, we employ Royston-Parmar spline models to extrapolate the survival curves to make a reasonable decision. Based on a real-world data example, we show that our approach can save a trial that would otherwise end with an inconclusive result. Additionally, our simulation studies demonstrate a sufficient power performance while maintaining more flexibility.
title Adaptive weight selection for time-to-event data under non-proportional hazards
topic Methodology
62N03
G.3.16
url https://arxiv.org/abs/2409.15145