The FORSS Framework for Sample Size and Power Calculations With Win Statistics for Hierarchical Endpoints

Fuente: arXiv
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Autori principali: Zhang, Baoshan, Barnhart, Huiman X., Wu, Yuan, Matsouaka, Roland A.
Natura: Preprint
Pubblicazione: 2026
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author Zhang, Baoshan
Barnhart, Huiman X.
Wu, Yuan
Matsouaka, Roland A.
author_facet Zhang, Baoshan
Barnhart, Huiman X.
Wu, Yuan
Matsouaka, Roland A.
contents Win statistics have gained increasing popularity as primary analysis methods for clinical trials with hierarchical endpoints (HEs) as primary endpoints. However, existing sample size and power calculation approaches in trial design still face several limitations and challenges: simulation-based approaches are computationally intensive, while existing formula-based methods often rely on simplifying assumptions such as independence among HEs, or require specification of overall win statistics and tie probability that are difficult to elicit a priori in practice. To address these challenges, we propose the FORSS framework, a FORmula-based Super-Sample approach that allows investigators to specify marginal treatment effects using familiar metrics (e.g., hazard ratios, mean differences, and risk differences) together with a flexible joint working distribution for the HEs. Rather than repeatedly simulating full trials at each candidate sample size, FORSS uses super-samples to estimate the population-level plug-in quantities required by analytical formulas for both power and sample size calculation. We evaluated the performance of the proposed FORSS through extensive simulation studies. The results show that the formula-based FORSS closely matches empirical power across a wide range of scenarios while maintaining Type~I error rates near the nominal 5\% level. An illustration based on the HEART-FID trial further shows that endpoint-dependence specifications can materially affect projected power and required sample size when planning trials with HEs.
format Preprint
id arxiv_https___arxiv_org_abs_2605_17240
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle The FORSS Framework for Sample Size and Power Calculations With Win Statistics for Hierarchical Endpoints
Zhang, Baoshan
Barnhart, Huiman X.
Wu, Yuan
Matsouaka, Roland A.
Methodology
Win statistics have gained increasing popularity as primary analysis methods for clinical trials with hierarchical endpoints (HEs) as primary endpoints. However, existing sample size and power calculation approaches in trial design still face several limitations and challenges: simulation-based approaches are computationally intensive, while existing formula-based methods often rely on simplifying assumptions such as independence among HEs, or require specification of overall win statistics and tie probability that are difficult to elicit a priori in practice. To address these challenges, we propose the FORSS framework, a FORmula-based Super-Sample approach that allows investigators to specify marginal treatment effects using familiar metrics (e.g., hazard ratios, mean differences, and risk differences) together with a flexible joint working distribution for the HEs. Rather than repeatedly simulating full trials at each candidate sample size, FORSS uses super-samples to estimate the population-level plug-in quantities required by analytical formulas for both power and sample size calculation. We evaluated the performance of the proposed FORSS through extensive simulation studies. The results show that the formula-based FORSS closely matches empirical power across a wide range of scenarios while maintaining Type~I error rates near the nominal 5\% level. An illustration based on the HEART-FID trial further shows that endpoint-dependence specifications can materially affect projected power and required sample size when planning trials with HEs.
title The FORSS Framework for Sample Size and Power Calculations With Win Statistics for Hierarchical Endpoints
topic Methodology
url https://arxiv.org/abs/2605.17240