Clinical Trials Commons^™

Bayesian Designs For Two-Arm Clinical Trials With Time-To-Event Endpoints: Incorporating Historical Data Through Power Priors, Sara Hajraf H. Almutiri

Mathematics & Statistics ETDs

Bayesian methods provide a flexible framework for time-to-event analysis by incorporating prior information. The power prior offers a systematic way to borrow information from historical data. This approach is especially valuable in clinical research, where historical data can enhance inference in early-phase trials with limited sample sizes. This dissertation develops Bayesian approaches for two-arm survival studies using both closed-form and simulation-based methods. The closed-form inference is derived under exponential and Weibull survival models. Under the proportional hazards framework, the posterior is derived through a normal approximation to the log hazard ratio, allowing inference on the treatment effect when the variance …

Efficacy Analysis In Clinical Trials: A Comprehensive Review Of Statistical And Machine Learning Approaches, Dhrubajyoti Ghosh, Samhita Pal

Faculty Articles

Efficacy testing is a cornerstone of clinical trials, ensuring that medical interventions achieve their intended therapeutic effects. Over the decades, a wide range of statistical methodologies have been developed to address the complexities of clinical trial data, including parametric, nonparametric, Bayesian, and machine learning approaches. Parametric methods, such as t-tests, ANOVA, and LMMs, have traditionally been the foundation of efficacy testing due to their efficiency under well-defined assumptions. Nonparametric techniques, including the Friedman test, Brunner-Munzel test, and modern extensions like nparLD, have emerged as robust alternatives, particularly for skewed, ordinal, or non-normal data. Bayesian methodologies have enabled the incorporation of …

Variance Shrinkage In Dunnett-Type Multiple Comparisons With Missing Data, Md Habibullah

UNF Graduate Theses and Dissertations

Dunnett’s procedure is widely used for comparing multiple treatments with a control, but its application becomes challenging in the presence of missing data and multiple com- parisons. An improved Dunnett-type procedure addresses this by using multiple imputation under Rubin’s framework and constructing unified confidence intervals based on a multi- variate t distribution, allowing valid simultaneous inference while controlling the family-wise error rate (FWER). This work further extends the method by incorporating shrinkage-based variance estimation. Specifically, individual group variances are shrunk toward a common value to improve stability. This approach is particularly effective when group variances are similar or moderately different, …

Evaluating Alpha Spending Functions Applied To Observational Time-To-Event Analysis, Moses Torgbenu

Electronic Theses and Dissertations

This thesis explores the theoretical foundation of the alpha spending approach and extends its application beyond the conventional setting of randomized controlled trials (RCTs) to observational studies with time to event analyses. In these less structured environments, key design parameters such as the total number of events are often unknown, posing challenges for the standard implementation of sequential analysis methods.

Through simulation studies, this research delivers several important contributions. First, it presents a modified approach that uses calendar time to define the timing of interim analyses while relying on event-based information to estimate the correlation among test statistics. This adjustment …

Discounting Effect Size When Borrowing External Data In Clinical Studies, Zhuanzhuan Ma, Chul Ahn, Bin Wang, Xuefeng Li

Research Symposium

Background: When borrowing information from external data to augment a current trial, many available methods discount the sample size but retain the effect size from previous studies. Discounting the sample size is just one way to discount the prior information. It may not be appropriate if the underlying assumption of unbiased treatment effect does not hold, for example, when the treatment effect in the historical study is likely higher than the one expected in the current trial.

Methods: To tackle this potential issue, we study some methods to shrink the effect size from previous studies assuming that the prior effect …

Leveraging Bayesian And Classical Techniques For Survival Analysis Using The Weibull-Rayleigh Distribution, Mahmoud Mansour, Rashad El-Sagheer, Nagwa Mohamed

Basic Science Engineering

This paper contributes to an extensive analysis of the Weibull-Rayleigh distribution (WRD), including Bayesian inference for randomly censored data. The WRD is a versatile model that fits various types of survival data, especially in situations including censoring, commonly found in biostatistics and engineering reliability research. The research investigates the derivation of the WRD’s probability density and cumulative distribution functions, employing maximum likelihood estimation (MLE) and Bayesian estimating techniques to accurately infer parameters. Gamma priors are utilized in Bayesian analysis, and approximate Bayesian estimates are derived by Gibbs sampling and Lindley’s approximation methods. An actual dataset that represents leukemia-free survival times …

High Fat Diet & Social Isolation: Interactive Effects On Pain, Cognition, & Neuroinflammation, Ian M. Campuzano

Research Psychology Theses

Prior research has established a role for both social isolation and exposure to high fat Western diets in altering a range of behaviors from reduced memory performance to increased depression-like behaviors. The present study scrutinizes the interplay among these variables during the peri-adolescent developmental phase, utilizing Long-Evans rats as the experimental model. Our overarching hypothesis is that rats exposed to either social isolation, a high-fat diet, or both will result in heightened pain sensitivity, diminished cognitive flexibility, and increased neuroinflammatory responses within brain regions implicated in sociability, cognition, memory, and pain processing. Behavioral flexibility will be assessed using a maze-based …

An Improved Bayesian Pick-The-Winner (Ibpw) Design For Randomized Phase Ii Clinical Trials, Wanni Lei, Maosen Peng, Xi K. Zhou

COBRA Preprint Series

Phase II clinical trials play a pivotal role in drug development by screening a large number of drug candidates to identify those with promising preliminary efficacy for phase III testing. Trial designs that enable efficient decision-making with small sample sizes and early futility stopping while controlling for type I and II errors in hypothesis testing, such as Simon’s two-stage design, are preferred. Randomized multi-arm trials are increasingly used in phase II settings to overcome the limitations associated with using historical controls as the reference. However, how to effectively balance efficiency and accurate decision-making continues to be an important research topic. …

Formulating An Efficient Statistical Test Using The Goodness Of Fit Approach With Applications To Real-Life Data, S. A. Qaid, S. E. Abo Youssef Prof., Mahmoud Mansour

Basic Science Engineering

Statistical tests are very important for researchers to make decisions. In particular, when the tests are non-parametric, they are of greater importance because they can be applied to a wide range of data sets regardless of knowing the distribution of these data. Researchers are therefore racing to obtain efficient tests for making good decisions based on the results of these tests. In this study, NBU (2)L was used based on the goodness of fit approach to present an efficient statistical test. The efficiency of the proposed test was computed, and the results were compared to those of other tests. Critical …

Forecasting Remission Time Of A Treatment Method For Leukemia As An Application To Statistical Inference Approach, Ahmed Galal Atia, Mahmoud Mansour, Rashad Mohamed El-Sagheer, B. S. El-Desouky

Basic Science Engineering

In this paper, Weibull-Linear Exponential distribution (WLED) has been investigated whether being it is a well-fit distribution to a clinical real data. These data represent the duration of remission achieved by a certain drug used in the treatment of leukemia for a group of patients. The statistical inference approach is used to estimate the parameters of the WLED through the set of the fitted data. The estimated parameters are utilized to evaluate the survival and hazard functions and hence assessing the treatment method through forecasting the duration of remission times of patients. A two-sample prediction approach has been applied to …

Novel Inference Methods For Generalized Linear Models Using Shrinkage Priors And Data Augmentation., Arinjita Bhattacharyya

Electronic Theses and Dissertations

Generalized linear models have broad applications in biostatistics and sociology. In a regression setup, the main target is to find a relevant set of predictors out of a large collection of covariates. Sparsity is the assumption that only a few of these covariates in a regression setup have a meaningful correlation with an outcome variate of interest. Sparsity is incorporated by regularizing the irrelevant slopes towards zero without changing the relevant predictors and keeping the resulting inferences intact. Frequentist variable selection and sparsity are addressed by popular techniques like Lasso, Elastic Net. Bayesian penalized regression can tackle the curse of …

Generalization Of Kullback-Leibler Divergence For Multi-Stage Diseases: Application To Diagnostic Test Accuracy And Optimal Cut-Points Selection Criterion, Chen Mo

College of Graduate Studies: Theses & Dissertations

The Kullback-Leibler divergence (KL), which captures the disparity between two distributions, has been considered as a measure for determining the diagnostic performance of an ordinal diagnostic test. This study applies KL and further generalizes it to comprehensively measure the diagnostic accuracy test for multi-stage (K > 2) diseases, named generalized total Kullback-Leibler divergence (GTKL). Also, GTKL is proposed as an optimal cut-points selection criterion for discriminating subjects among different disease stages. Moreover, the study investigates a variety of applications of GTKL on measuring the rule-in/out potentials in the single-stage and multi-stage levels. Intensive simulation studies are conducted to compare the performance …

Three Essays On Health Economics And Policy Evaluation, Shishir Shakya

Graduate Theses, Dissertations, and Problem Reports (ETD)

This dissertation consists of three essays on the U.S. Health care policy. Each paragraph below refers to the three abstracts for the three chapters in this dissertation, respectively. I provide quantitative evidence on how much Prescription Drug Monitoring Programs (PDMPs) affects the retail opioid prescribing behaviors. Using the American Community Survey (ACS), I retrieve county-level high dimensional panel data set from 2010 to 2017. I employ three separate identification strategies: difference-in-difference, double selection post-LASSO, and spatial difference-in-difference. I compare how the retail opioid prescribing behaviors of counties, that are mandatory for prescribers to check the PDMP before prescribing controlled substances …

A Two-Stage Design For Comparing Binomial Treatments With A Standard, Cecelia K. Schmidt

UNF Graduate Theses and Dissertations

We propose a method for comparing success rates of several populations among each other and against a desired standard success rate. This design is appropriate for a situation in which all experimental treatments have only two outcomes that can be considered “success”and “failure” respectively. The goal is to identify which treatment has the highest rate of success that is also higher than the desired standard. The design combines elements of both hypothesis testing and statistical selection. At the first stage, if none of the samples have a number of successes above the appropriate standard for the design, the experiment is …

Natural Lead-In Approaches To Response-Adaptive Allocation In Clinical Trials, Erin E. Donahue

Theses and Dissertations

Response-adaptive (RA) allocation designs can be implemented in clinical trials to skew the allocation of incoming subjects toward the better performing treatment group based on the previously accrued subjects' responses. These designs alleviate potential ethical concerns of equally allocating subjects in a trial when one treatment arm is inferior. The RA design can be generalized to include covariate information in the covariate-adjusted response-adaptive (CARA) design, which aims to maximize treatment successes conditional on a set of patient characteristics. While RA and CARA designs can improve the treatment of patients, they have unstable estimators and increased variability in early stages of …

Unified Methods For Feature Selection In Large-Scale Genomic Studies With Censored Survival Outcomes, Lauren Spirko-Burns, Karthik Devarajan

COBRA Preprint Series

One of the major goals in large-scale genomic studies is to identify genes with a prognostic impact on time-to-event outcomes which provide insight into the disease's process. With rapid developments in high-throughput genomic technologies in the past two decades, the scientific community is able to monitor the expression levels of tens of thousands of genes and proteins resulting in enormous data sets where the number of genomic features is far greater than the number of subjects. Methods based on univariate Cox regression are often used to select genomic features related to survival outcome; however, the Cox model assumes proportional hazards …

Burden Of Atopic Dermatitis In The United States: Analysis Of Healthcare Claims Data In The Commercial, Medicare, And Medi-Cal Databases, Sulena Shrestha, Raymond Miao, Li Wang, Jingdong Chao, Huseyin Yuce, Wenhui Wei

Publications and Research

Comparative data on the burden of atopic dermatitis (AD) in adults relative to the general population are limited. We performed a large-scale evaluation of the burden of disease among US adults with AD relative to matched non-AD controls, encompassing comorbidities, healthcare resource utilization (HCRU), and costs, using healthcare claims data. The impact of AD disease severity on these outcomes was also evaluated.

Denoising Tandem Mass Spectrometry Data, Felix Offei

Electronic Theses and Dissertations

Protein identification using tandem mass spectrometry (MS/MS) has proven to be an effective way to identify proteins in a biological sample. An observed spectrum is constructed from the data produced by the tandem mass spectrometer. A protein can be identified if the observed spectrum aligns with the theoretical spectrum. However, data generated by the tandem mass spectrometer are affected by errors thus making protein identification challenging in the field of proteomics. Some of these errors include wrong calibration of the instrument, instrument distortion and noise. In this thesis, we present a pre-processing method, which focuses on the removal of noisy …

Inference On The Stress-Strength Model From Weibull Gamma Distribution, Mahmoud Mansour, Rashad El-Sagheer, M. A. W. Mahmoud Prof.

Basic Science Engineering

No abstract provided.

Further Advances For The Sequential Multiple Assignment Randomized Trial (Smart), Tianjiao Dai

Dissertations and Theses (Open Access)

ABSTRACT

FURTHER ADVANCES FOR THE SEQUENTIAL MULTIPLE ASSIGNMENT RANDOMIZED TRIAL (SMART)

Tianjiao Dai, M.S.

Advisory Professor: Sanjay Shete, Ph.D.

Sequential multiple assignment randomized trial (SMART) designs have been developed these years for studying adaptive interventions. In my Ph.D. study, I mainly investigate how to further improve SMART designs and optimize the interventions for each individual in the trial. My dissertation has focused on two topics of SMART designs.

1) Developing a novel SMART design that can reduce the cost and side effects associated with the interventions and proposing the corresponding analytic methods. I have developed a time-varying SMART design in …

Studying The Optimal Scheduling For Controlling Prostate Cancer Under Intermittent Androgen Suppression, Sunil K. Dhar, Hans R. Chaudhry, Bruce G. Bukiet, Zhiming Ji, Nan Gao, Thomas W. Findley

Harvard University Biostatistics Working Paper Series

This retrospective study shows that the majority of patients’ correlations between PSA and Testosterone during the on-treatment period is at least 0.90. Model-based duration calculations to control PSA levels during off-treatment are provided. There are two pairs of models. In one pair, the Generalized Linear Model and Mixed Model are both used to analyze the variability of PSA at the individual patient level by using the variable “Patient ID” as a repeated measure. In the second pair, Patient ID is not used as a repeated measure but additional baseline variables are included to analyze the variability of PSA.

Models For Hsv Shedding Must Account For Two Levels Of Overdispersion, Amalia Magaret

UW Biostatistics Working Paper Series

We have frequently implemented crossover studies to evaluate new therapeutic interventions for genital herpes simplex virus infection. The outcome measured to assess the efficacy of interventions on herpes disease severity is the viral shedding rate, defined as the frequency of detection of HSV on the genital skin and mucosa. We performed a simulation study to ascertain whether our standard model, which we have used previously, was appropriately considering all the necessary features of the shedding data to provide correct inference. We simulated shedding data under our standard, validated assumptions and assessed the ability of 5 different models to reproduce the …

Depicting Estimates Using The Intercept In Meta-Regression Models: The Moving Constant Technique, Blair T. Johnson Dr., Tania B. Huedo-Medina Dr.

CHIP Documents

In any scientific discipline, the ability to portray research patterns graphically often aids greatly in interpreting a phenomenon. In part to depict phenomena, the statistics and capabilities of meta-analytic models have grown increasingly sophisticated. Accordingly, this article details how to move the constant in weighted meta-analysis regression models (viz. “meta-regression”) to illuminate the patterns in such models across a range of complexities. Although it is commonly ignored in practice, the constant (or intercept) in such models can be indispensible when it is not relegated to its usual static role. The moving constant technique makes possible estimates and confidence intervals at …

Software Internationalization: A Framework Validated Against Industry Requirements For Computer Science And Software Engineering Programs, John Huân Vũ

Master's Theses

View John Huân Vũ's thesis presentation at http://youtu.be/y3bzNmkTr-c.

In 2001, the ACM and IEEE Computing Curriculum stated that it was necessary to address "the need to develop implementation models that are international in scope and could be practiced in universities around the world." With increasing connectivity through the internet, the move towards a global economy and growing use of technology places software internationalization as a more important concern for developers. However, there has been a "clear shortage in terms of numbers of trained persons applying for entry-level positions" in this area. Eric Brechner, Director of Microsoft Development Training, suggested …