Abstract
This chapter presents the motivations for, and consequences of, executing multiple statistical analyses in clinical trials. Logistical efficiency, the desire to build a causal argument, and the need to explore and develop unanticipated results, are appropriate and powerful factors that motivate the inclusion of multiple analyses in these randomized studies. However, their incorporation may produce results which can be difficult to integrate with the idea of controlling the type I error rate. The need to minimize the type I error rate in a clinical trial is developed, followed by an elementary introduction to one of the most useful tools for controlling type I error rates—the Bonferroni inequality. Alternative methods of controlling the type I error rate are then briefly discussed. The chapter ends by combining (1) the motivation for the prospective plan of an experiment and (2) the need to control the type I error rate into a framework to guide the design of a clinical trial. This final integration (Table 3.3) describes the three ways in which multiple analyses in clinical trials are carried out, and the implications for each of their interpretations. This result will be the basis for the development of the multiple analysis tools to which the rest of the book is devoted.
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References
Budde, M., Bauer, P. (1989). Multiple test procedures in clinical dose finding studies. Journal of the American Statistical Association 84:792–796.
Shepherd, J., Cobbe, S.M., Ford, I., et al. (1995). Prevention of CAD with pravastatin in men with hypercholesterolemia. New England Journal of Medicine 333:1301–7.
Sacks, F.M., Pfeffer, M.A., Moyé, L.A., Rouleau, J.L., Rutherford, J.D., Cole, T.G., Brown, L., Warnica, J.W., Arnold, J.M.O., Wun, C.C., Davist, B.R., Braunwald. E. (1996). The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. New England Journal of Medicine 335:1001–9.
Scandinavian Simvastatin Survival Study Group. (1994). Randomized trial of cholesterol lowering in 4444 patients with CAD: the Scandinavian Simvastatin Survival Study (4S). Lancet 344:1383–9.
Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. (1998). Prevention of cardiovascular events and death with pravastatin in patients with CAD and a broad range of initial cholesterol levels. New England Journal of Medicine 339:1349–1357.
Food and Drug Modernization Act of 1997. (November 21, 1997). Public Law.105-115;21USC 355a;111Stat. 2295.
Nester, M.R., (1996). An applied statistician’s creed. Applied Statistics 45: 4401–410.
Rothman, R.J. No adjustments are needed for multiple comparisons. Epidemiology 1:43–46.
Fisher, L.D., Moyé, L.A. (1999). Carvedilol and the Food and Drug Administration Approval Process: An Introduction. Controlled Clinical Trials 20:1–15.
Fisher, L.D. (1999). Carvedilol and the FDA approval process: the FDA paradigm and reflections upon hypothesis testing. Controlled Clinical Trials 20:16–39.
Moyé, L.A. (1999). P-Value Interpretation in Clinical Trials. The Case for Discipline. Controlled Clinical Trials 20:40–49.
Hochberg, Y., Tamhane, A.C. (1987). Multiple Comparison Procedures, New York, Wiley.
Westfall, P.H., Young S.S. (1993). Resampling Based Multiple Testing: Examples and Methods for P-Value Adjustment. New York. Wiley.
Pocock, R.J., Farewell, V.T. (1996). Multiplicity consideration in the design and analysis of clinical trials. Journal of the Royal Statistical Society A 159:93–110.
Adams, C. (2002). At FDA, approving cancer treatments can be an ordeal. The Wall Street Journal. December 11, p 1.
Senn, S. (1997). Statistical Issues in Drug Development. Chichester, Wiley, Section 15.2.1.
Miller, R.G. (1981) Simultaneous Statistical Inference, 2nd ed. New York Springer.
Bonferroni, C.E. (1935). Il calcolo delle assicurazioni su gruppi di teste. In Studi in Onore del Professore Salvatore Ortu Carboni. Rome, 13–60.
Bonferroni, C.E. (1936). Teoria statistica delle classi e calcolo delle probabilità . Pubblicazioni del R Istituto Superiore di Scienze Economiche e Commerciali di Firenze 8:3–62.
Dunn, O.J. (1959). Confidence intervals for the means of dependent, normally distributed variables. Journal of the American Statistical Association 54:613–621.
Dunn, O.J. (1961). Multiple comparisons among means. Journal of the American Statistical Asssociation 56:52–54.
Zhang, J., Qwuan, H., Ng, J., Stepanavage, M.E. (1997). Some statistical methods for mulitple endpoints in clinical trials. Controlled Clinical Trials 18:204–221.
Wright, S.P. (1992). Adjusted P-values for simultaneous inference. Biometrics 48:1005–1013.
Simes, R.J. (1986). An improved Bonferroni procedure for multiple tests of significance. Biometrika 73:819–827.
Holm, S. (1979). A simple sequentially rejective multiple test procedures. Scandinavian Journal of Statistics 6:65–70.
Hommel, G. (1988). A stepwise rejective multiple test procedure based on a modified Bonferroni test. Biometrika 75:383–386.
Shaffer, J.P. (1986). Modified sequentially rejective multiple test procedures. Journal of the American Statistical Association 81:826–831.
Bland, J.M., Altman, D.G. (1994). Statistics notes: One and two-sided tests of significance. British Medical Journal 309:248.
Dunnett, C.W., Gent, M. (1996). An alternative to the use of two-sided tests in clinical trials. Statistics in Medicine 15:1729–1738.
Knottnerus J.A., Bouter L.M. (2001). Commentary The ethics of sample size: two-sided testing and one-sided thinking. Journal of Clinical Epidemiology 54:109–110.
Moyé, L.A. (2000). Statistical Reasoning in Medicine: The Intuitive P-Value Primer. New York, Springer. Chapter 6.
Moyé, L.A., Tita, A. (2002). Ethics and Hypothesis Testing Complexity Circulation 105:3062–3065.
Westfall P.H., Young S.S., Wright S.P. (1993). Adjusting p-values for multiplicity. Biometrics 49:941–945.
Westfall, P.H., Young, S. P-value adjustments for mulitple tests in multivariate binomial models. Journal of the American Statistical Association 84:780–786.
Westfall, P.H., Krishnen, A., Young, S.S. (1998). Using prior information to allocate significance levels for multiple endpoints. Statistics in Medicine 17:2107–2119.
Berger, V. (1998). Admissibility of Exact Conditional Tests of Stochastic Order. Journal of Statistical Planning and Inference 66:39–50.
Miller RG. (1977). Developements in multiple comparisons 1966–1976. Journal of the American Statistical Association 72:779–788.
Edwards, D., Berry, J.J. (1987). The efficiency of simulation-based multiple comparisons. Biometrics 43:913–928.
Einot, I., Gabriel, E.R. (1975). A study of powers of several methods of multiple comparisons. Journal of the American Statistical Association 70:574–583.
O’Brien, P.C. (1984). Procedures for comparing samples with multiple end-points. Biometrics 40:1079–1087.
Simes, R.J. (1986). An improved Bonferroni procedure for multiple tests of significance. Biometrika 73:751–754.
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(2003). The Lure and Complexity of Multiple Analyses. In: Multiple Analyses in Clinical Trials. Statistics for Biology and Health. Springer, New York, NY. https://doi.org/10.1007/0-387-21813-0_4
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DOI: https://doi.org/10.1007/0-387-21813-0_4
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