Adjusting for early treatment termination in comparative clinical trials.

Adjusting for early treatment termination in comparative clinical trials.
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在比较临床试验中调整早期治疗终止。

DOI:
10.1002/sim.4780091204
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发表时间:
1990
影响因子:
2
通讯作者:
Robins,JM
Robins,JM
中科院分区:
医学3区
文献类型:
--
作者:
Lagakos,SW;Lim,LL;Robins,JM

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在长期治疗的临床试验中,患者往往比计划的更早终止治疗。在分析失败时间数据时,一种解释早期治疗终止的方法审查治疗终止时的失败。然而,一般说来,这并不能得出有效的推论,即如果治疗没有终止,失败的时间分布将会发生。相比之下,意向治疗分析基于失败时间,无论治疗是否终止以及何时终止,总是得出关于失败时间无条件分布的有效推论。早期终止治疗不会扭曲意向治疗试验的大小(I类错误率),但可能导致功率损失。对普通LOGRANK测试的修改可以在不影响测试大小的情况下恢复一些损失的功率,当仍在接受治疗的高危患者的比例在观察到失败的期间发生重大变化时,这一修改最有用。将修改后的测试扩展到包括地层是简单的,尽管重要的设计问题需要进一步研究。
In clinical trials of long‐term therapies, patients often terminate their treatments earlier than planned. When analysing time‐to‐failure data, one approach to account for early treatment termination censors failure at the time of termination of therapy. In general, however, this does not produce valid inferences about the distribution of time to failure that would have occurred had treatment not been terminated. In contrast, intent‐to‐treat analyses, which are based on time to failure regardless of whether and when treatment is terminated, always produce valid inferences about the unconditional distribution of time to failure. Early treatment termination does not distort the size (type I error rate) of intent‐to‐treat tests but can cause a loss in power. Modifications to ordinary logrank tests can be used to recover some of the lost power without affecting test size, and can be most useful when the proportion of at‐risk patients still taking their treatment changes substantially during periods when failures are observed. Extensions of the modified test to include strata are straightforward, although important design questions require further research.
DOI: 10.2307/2531154
发表时间: 1984-01-01
期刊: BIOMETRICS
影响因子: 1.9
作者:
LAGAKOS, SW;SCHOENFELD, DA
通讯作者: SCHOENFELD, DA
DOI: 10.1016/0197-2456(82)90037-x
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期刊: CONTROLLED CLINICAL TRIALS
影响因子: --
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DOI: 10.1289/ehp.8563211
发表时间: 1985
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作者:
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