Using Individualized Treatment Effects to Assess Treatment Effect Heterogeneity

Fuente: Wiley Open Access
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Auteurs principaux: Konstantinos Sechidis, Cong Zhang, Sophie Sun, Yao Chen, Asher Spector, Björn Bornkamp
Format: Artículo Open Access
Publié: Wiley 2025
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author Konstantinos Sechidis
Cong Zhang
Sophie Sun
Yao Chen
Asher Spector
Björn Bornkamp
author_facet Konstantinos Sechidis
Cong Zhang
Sophie Sun
Yao Chen
Asher Spector
Björn Bornkamp
Konstantinos Sechidis
Cong Zhang
Sophie Sun
Yao Chen
Asher Spector
Björn Bornkamp
collection Wiley Open Access
contents Using Individualized Treatment Effects to Assess Treatment Effect Heterogeneity Konstantinos Sechidis Cong Zhang Sophie Sun Yao Chen Asher Spector Björn Bornkamp Statistics in Medicine ABSTRACT Assessing treatment effect heterogeneity (TEH) in clinical trials is crucial, as it provides insights into the variability of treatment responses among patients, influencing key decisions related to drug development. Furthermore, it can lead to personalized medicine by tailoring treatments to individual patient characteristics. This paper introduces novel methodologies for assessing treatment effects using the individualized treatment effect as a basis. To estimate this effect, we use a doubly robust (DR) learner to infer a pseudo‐outcome that reflects the causal contrast. This pseudo‐outcome is then used to perform three objectives: (1) a global test for heterogeneity, (2) ranking covariates based on their influence on effect modification, and (3) providing estimates of the individualized treatment effect. We compare the DR‐learner with various alternatives and competing methods in a simulation study, and also use it to assess heterogeneity in a pooled analysis of five Phase III trials in psoriatic arthritis (PsA). By integrating these methods with the recently proposed Workflow to Assess Treatment Effect Heterogeneity in Drug Development for Clinical Trial Sponsors (WATCH) workflow, we provide a robust framework for analyzing TEH, offering insights that enable more informed decision‐making in this challenging area. 10.1002/sim.70324 http://onlinelibrary.wiley.com/termsAndConditions#am
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spellingShingle Using Individualized Treatment Effects to Assess Treatment Effect Heterogeneity
Konstantinos Sechidis
Cong Zhang
Sophie Sun
Yao Chen
Asher Spector
Björn Bornkamp
Statistics in Medicine
Using Individualized Treatment Effects to Assess Treatment Effect Heterogeneity Konstantinos Sechidis Cong Zhang Sophie Sun Yao Chen Asher Spector Björn Bornkamp Statistics in Medicine ABSTRACT Assessing treatment effect heterogeneity (TEH) in clinical trials is crucial, as it provides insights into the variability of treatment responses among patients, influencing key decisions related to drug development. Furthermore, it can lead to personalized medicine by tailoring treatments to individual patient characteristics. This paper introduces novel methodologies for assessing treatment effects using the individualized treatment effect as a basis. To estimate this effect, we use a doubly robust (DR) learner to infer a pseudo‐outcome that reflects the causal contrast. This pseudo‐outcome is then used to perform three objectives: (1) a global test for heterogeneity, (2) ranking covariates based on their influence on effect modification, and (3) providing estimates of the individualized treatment effect. We compare the DR‐learner with various alternatives and competing methods in a simulation study, and also use it to assess heterogeneity in a pooled analysis of five Phase III trials in psoriatic arthritis (PsA). By integrating these methods with the recently proposed Workflow to Assess Treatment Effect Heterogeneity in Drug Development for Clinical Trial Sponsors (WATCH) workflow, we provide a robust framework for analyzing TEH, offering insights that enable more informed decision‐making in this challenging area. 10.1002/sim.70324 http://onlinelibrary.wiley.com/termsAndConditions#am
title Using Individualized Treatment Effects to Assess Treatment Effect Heterogeneity
topic Statistics in Medicine
url https://onlinelibrary.wiley.com/doi/10.1002/sim.70324