A unified Bayesian framework for bias adjustment in multiple comparisons from clinical trials

Fuente: Wiley Open Access
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Autores principales: Yu Du, Jianghao Li, Sohini Raha, Yongming Qu
Formato: Artículo Open Access
Publicado: Wiley 2024
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author Yu Du
Jianghao Li
Sohini Raha
Yongming Qu
author_facet Yu Du
Jianghao Li
Sohini Raha
Yongming Qu
Yu Du
Jianghao Li
Sohini Raha
Yongming Qu
collection Wiley Open Access
contents A unified Bayesian framework for bias adjustment in multiple comparisons from clinical trials Yu Du Jianghao Li Sohini Raha Yongming Qu Statistics in Medicine In clinical trials, multiple comparisons arising from various treatments/doses, subgroups, or endpoints are common. Typically, trial teams focus on the comparison showing the largest observed treatment effect, often involving a specific treatment pair and endpoint within a subgroup. These findings frequently lead to follow‐up pivotal studies, many of which do not confirm the initial positive results. Selection bias occurs when the most promising treatment, subgroup, or endpoint is chosen for further development, potentially skewing subsequent investigations. Such bias can be defined as the deviation in the observed treatment effects from the underlying truth. In this article, we propose a general and unified Bayesian framework to address selection bias in clinical trials with multiple comparisons. Our approach does not require a priori specification of a parametric distribution for the prior, offering a more flexible and generalized solution. The proposed method facilitates a more accurate interpretation of clinical trial results by adjusting for such selection bias. Through simulation studies, we compared several methods and demonstrated their superior performance over the normal shrinkage estimator. We recommended the use of Bayesian Model Averaging estimator averaging over Gaussian Mixture Models as the prior distribution based on its performance and flexibility. We applied the method to a multicenter, randomized, double‐blind, placebo‐controlled study investigating the cardiovascular effects of dulaglutide. 10.1002/sim.10064 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1002/sim.10064
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spellingShingle A unified Bayesian framework for bias adjustment in multiple comparisons from clinical trials
Yu Du
Jianghao Li
Sohini Raha
Yongming Qu
Statistics in Medicine
A unified Bayesian framework for bias adjustment in multiple comparisons from clinical trials Yu Du Jianghao Li Sohini Raha Yongming Qu Statistics in Medicine In clinical trials, multiple comparisons arising from various treatments/doses, subgroups, or endpoints are common. Typically, trial teams focus on the comparison showing the largest observed treatment effect, often involving a specific treatment pair and endpoint within a subgroup. These findings frequently lead to follow‐up pivotal studies, many of which do not confirm the initial positive results. Selection bias occurs when the most promising treatment, subgroup, or endpoint is chosen for further development, potentially skewing subsequent investigations. Such bias can be defined as the deviation in the observed treatment effects from the underlying truth. In this article, we propose a general and unified Bayesian framework to address selection bias in clinical trials with multiple comparisons. Our approach does not require a priori specification of a parametric distribution for the prior, offering a more flexible and generalized solution. The proposed method facilitates a more accurate interpretation of clinical trial results by adjusting for such selection bias. Through simulation studies, we compared several methods and demonstrated their superior performance over the normal shrinkage estimator. We recommended the use of Bayesian Model Averaging estimator averaging over Gaussian Mixture Models as the prior distribution based on its performance and flexibility. We applied the method to a multicenter, randomized, double‐blind, placebo‐controlled study investigating the cardiovascular effects of dulaglutide. 10.1002/sim.10064 http://onlinelibrary.wiley.com/termsAndConditions#vor
title A unified Bayesian framework for bias adjustment in multiple comparisons from clinical trials
topic Statistics in Medicine
url https://onlinelibrary.wiley.com/doi/10.1002/sim.10064