Bruce W. Turnbull

Bio: Bruce W. Turnbull is an academic researcher from Cornell University. The author has contributed to research in topics: Sample size determination & Confidence interval. The author has an hindex of 42, co-authored 125 publications receiving 12726 citations. Previous affiliations of Bruce W. Turnbull include Durham University & University of Oxford.

Effects of Selenium Supplementation for Cancer Prevention in Patients With Carcinoma of the Skin: A Randomized Controlled Trial

Abstract: Objective. —To determine whether a nutritional supplement of selenium will decrease the incidence of cancer. Design. —A multicenter, double-blind, randomized, placebo-controlled cancer prevention trial. Setting. —Seven dermatology clinics in the eastern United States. Patients. —A total of 1312 patients (mean age, 63 years; range, 18-80 years) with a history of basal cell or squamous cell carcinomas of the skin were randomized from 1983 through 1991. Patients were treated for a mean (SD) of 4.5 (2.8) years and had a total follow-up of 6.4 (2.0) years. Interventions. —Oral administration of 200 μg of selenium per day or placebo. Main Outcome Measures. —The primary end points for the trial were the incidences of basal and squamous cell carcinomas of the skin. The secondary end points, established in 1990, were all-cause mortality and total cancer mortality, total cancer incidence, and the incidences of lung, prostate, and colorectal cancers. Results. —After a total follow-up of 8271 person-years, selenium treatment did not significantly affect the incidence of basal cell or squamous cell skin cancer. There were 377 new cases of basal cell skin cancer among patients in the selenium group and 350 cases among the control group (relative risk [RR], 1.10; 95% confidence interval [CI], 0.95-1.28), and 218 new squamous cell skin cancers in the selenium group and 190 cases among the controls (RR, 1.14; 95% CI, 0.93-1.39). Analysis of secondary end points revealed that, compared with controls, patients treated with selenium had a nonsignificant reduction in all-cause mortality (108 deaths in the selenium group and 129 deaths in the control group [RR, 0.83; 95% CI, 0.63-1.08]) and significant reductions in total cancer mortality (29 deaths in the selenium treatment group and 57 deaths in controls [RR, 0.50; 95% CI, 0.31-0.80]), total cancer incidence (77 cancers in the selenium group and 119 in controls [RR, 0.63; 95% CI, 0.47-0.85]), and incidences of lung, colorectal, and prostate cancers. Primarily because of the apparent reductions in total cancer mortality and total cancer incidence in the selenium group, the blinded phase of the trial was stopped early. No cases of selenium toxicity occurred. Conclusions. —Selenium treatment did not protect against development of basal or squamous cell carcinomas of the skin. However, results from secondary end-point analyses support the hypothesis that supplemental selenium may reduce the incidence of, and mortality from, carcinomas of several sites. These effects of selenium require confirmation in an independent trial of appropriate design before new public health recommendations regarding selenium supplementation can be made.

The Empirical Distribution Function with Arbitrarily Grouped, Censored, and Truncated Data

Abstract: SUMMARY This paper is concerned with the non-parametric estimation of a distribution function F, when the data are incomplete due to grouping, censoring and/or truncation. Using the idea of self-consistency, a simple algorithm is constructed and shown to converge monotonically to yield a maximum likelihood estimate of F. An application to hypothesis testing is indicated.

Group Sequential Methods with Applications to Clinical Trials

Abstract: INTRODUCTION About This Book Why Sequential Methods A Short History of Sequential and Group Sequential Methods Chapter Organization: A Roadmap Bibliography and Notes TWO-SIDED TESTS: INTRODUCTION Two-Sided Tests for Comparing Two Treatments with Normal Response of Known Variance A Fixed Sample Test Group Sequential Tests Pocock's Test O'Brien and Fleming's Test Properties of Pocock and O'Brien and Fleming Tests Other Tests Conclusions TWO-SIDED TESTS: GENERAL APPLICATIONS A Unified Formulation Applying the Tests with Equal Group Sizes Applying the Tests with Unequal Increments in Information Normal Linear Models Other Parametric Models Binary Data: Group Sequential Tests for Proportions The Group Sequential Log-Rank Test for Survival Data Group Sequential t-Tests ONE-SIDED TESTS Introduction The Power Family of One-Sided Group Sequential Tests Adapting Power Family Tests to Unequal Increments in Information Group Sequential One-Sided t-Tests Whitehead's Triangular Test TWO-SIDED TESTS WITH EARLY STOPPING UNDER THE NULL HYPOTHESIS Introduction The Power Family of Two-Sided, Inner Wedge Tests Whitehead's Double Triangular Test EQUIVALENCE TESTS Introduction One-Sided Tests of Equivalence Two-Sided Tests of Equivalence: Application to Comparative Bioavailability Studies Individual Bioequivalence: A One-Sided Test for Proportions Bibliography and Notes FLEXIBLE MONITORING: THE ERROR SPENDING APPROACH Unpredictable Information Sequences Two-Sided Tests One-Sided Tests Data Dependent Timing of Analyses Computations for Error Spending Tests ANALYSIS FOLLOWING A SEQUENTIAL TEST Introduction Distribution Theory Point Estimation P-Values Confidence intervals REPEATED CONFIDENCE INTERVALS Introduction Example: Difference of Normal Means Derived Tests: Use of RCIs to Aid Early Stopping Decisions Repeated P-Values Discussion STOCHASTIC CURTAILMENT Introduction Conditional Power Approach Predictive Power Approach A Parameter-Free Approach A Case Study with Survival Data Bibliography and Notes GENERAL GROUP SEQUENTIAL DISTRIBUTION THEORY Introduction A Standard Joint Distribution for Successive Estimates of a Parameter Vector Normal Linear Models Normal Linear Models with Unknown Variance: Group Sequential t-Tests Example: An Exact One-Sample Group Sequential t-Test General Parametric Models: Generalized Linear Models Connection with Survival Analysis BINARY DATA A Single Bernoulli Probability Two Bernoulli Probabilities The Odds Ratio and Multiple 2 x 2 Tables Case-Control and Matched Pair Analysis Logistic Regression: Adjusting for Covariates Bibliography and Notes SURVIVAL DATA Introduction The Log Rank Test The Stratified Log-Rank Test Group Sequential Methods for Survival Data with Covariates Repeated Confidence Intervals for a Hazard Ratio Example: A Clinical Trial for Carcinoma of the Oropharynx Survival Probabilities and Quantiles Bibliography and Notes INTERNAL PILOT STUDIES: SAMPLE SIZE RE-ESTIMATION The Role of an Internal Pilot Phase Sample Size Re-estimation for a Fixed Sample Test Sample Size Re-estimation in Group Sequential Tests MULTIPLE ENDPOINTS Introduction The Bonferroni Procedure A Group Sequential Hotelling Test A Group Sequential Version of O'Brien's Test Tests Based on other Global Statistics Tests Based on Marginal Criteria Bibliography and Notes MULTI-ARMED TRIALS Introduction Global Tests Monitoring Pairwise Comparisons Bibliography and Notes ADAPTIVE TREATMENT ASSIGNMENT A Multi-Stage Adaptive Design A Multi-Stage Adaptive Design with Time Trends Validity of Adaptive Multi-Stage Procedures Bibliography and Notes BAYESIAN APPROACHES The Bayesian Paradigm Stopping Rules Choice of Prior Distribution Discussion NUMERICAL COMPUTATIONS FOR GROUP SEQUENTIAL TESTS Introduction The Basic Calculation Error Probabilities and Sample Size Distributions Tests Defined by Error Spending Functions Analysis Following a Group Sequential Test Further Applications of Numerical Computation Computer Software

Decreased incidence of prostate cancer with selenium supplementation: results of a double-blind cancer prevention trial.

Abstract: Objective To test if supplemental dietary selenium is associated with changes in the incidence of prostate cancer. Patients and method A total of 974 men with a history of either a basal cell or squamous cell carcinoma were randomized to either a daily supplement of 200 μg of selenium or a placebo. Patients were treated for a mean of 4.5 years and followed for a mean of 6.5 years. Results Selenium treatment was associated with a significant (63%) reduction in the secondary endpoint of prostate cancer incidence during 1983–93. There were 13 prostate cancer cases in the selenium-treated group and 35 cases in the placebo group (relative risk, RR=0.37, P=0.002). Restricting the analysis to the 843 patients with initially normal levels of prostate-specific antigen (≤4 ng/mL), only four cases were diagnosed in the selenium-treated group and 16 cases were diagnosed in the placebo group after a 2 year treatment lag, (RR=0.26 P=0.009). There were significant health benefits also for the other secondary endpoints of total cancer mortality, and the incidence of total, lung and colorectal cancer. There was no significant change in incidence for the primary endpoints of basal and squamous cell carcinoma of the skin. In light of these results, the ‘blinded’ phase of this trial was stopped early. Conclusions Although selenium shows no protective effects against the primary endpoint of squamous and basal cell carcinomas of the skin, the selenium-treated group had substantial reductions in the incidence of prostate cancer, and total cancer incidence and mortality that demand further evaluation in well-controlled prevention trials.

Baseline characteristics and the effect of selenium supplementation on cancer incidence in a randomized clinical trial: a summary report of the Nutritional Prevention of Cancer Trial.

Abstract: The Nutritional Prevention of Cancer Trial was a randomized, clinical trial designed to evaluate the efficacy of selenium as selenized yeast (200 microg daily) in preventing the recurrence of nonmelanoma skin cancer among 1312 residents of the Eastern United States. Original secondary analyses through December 31, 1993 showed striking inverse associations between treatment and the incidence of total [hazard ratio (HR) = 0.61, 95% confidence interval (CI) = 0.46-0.82], lung, prostate, and colorectal cancer and total cancer mortality. This report presents results through February 1, 1996, the end of blinded treatment. Effect modification by baseline characteristics is also evaluated. The effects of treatment overall and within subgroups of baseline age, gender, smoking status, and plasma selenium were examined using incidence rate ratios and Cox proportional hazards models. Selenium supplementation reduced total (HR = 0.75, 95% CI = 0.58-0.97) and prostate (HR = 0.48, 95% CI = 0.28-0.80) cancer incidence but was not significantly associated with lung (HR = 0.74, 95% CI = 0.44-1.24) and colorectal (HR = 0.46, 95% CI = 0.21-1.02) cancer incidence. The effects of treatment on other site-specific cancers are also described. The protective effect of selenium was confined to males (HR = 0.67, 95% CI = 0.50-0.89) and was most pronounced in former smokers. Participants with baseline plasma selenium concentrations in the lowest two tertiles (<121.6 ng/ml) experienced reductions in total cancer incidence, whereas those in the highest tertile showed an elevated incidence (HR = 1.20, 95% CI = 0.77-1.86). The Nutritional Prevention of Cancer trial continues to show a protective effect of selenium on cancer incidence, although not all site-specific cancers exhibited a reduction in incidence. This treatment effect was restricted to males and to those with lower baseline plasma selenium concentrations.

The Design and Analysis of Experiments

Abstract: THE DESIGN AND ANALYSIS OF EXPERIMENTS. By Oscar Kempthorne. New York, John Wiley and Sons, Inc., 1952. 631 pp. $8.50. This book by a teacher of statistics (as well as a consultant for \"experimenters\") is a comprehensive study of the philosophical background for the statistical design of experiment. It is necessary to have some facility with algebraic notation and manipulation to be able to use the volume intelligently. The problems are presented from the theoretical point of view, without such practical examples as would be helpful for those not acquainted with mathematics. The mathematical justification for the techniques is given. As a somewhat advanced treatment of the design and analysis of experiments, this volume will be interesting and helpful for many who approach statistics theoretically as well as practically. With emphasis on the \"why,\" and with description given broadly, the author relates the subject matter to the general theory of statistics and to the general problem of experimental inference. MARGARET J. ROBERTSON

Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer

Abstract: bevacizumab, as compared with 10.3 months in the chemotherapy-alone group (hazard ratio for death, 0.79; P = 0.003). The median progression-free survival in the two groups was 6.2 and 4.5 months, respectively (hazard ratio for disease progression, 0.66; P<0.001), with corresponding response rates of 35% and 15% (P<0.001). Rates of clinically significant bleeding were 4.4% and 0.7%, respectively (P<0.001). There were 15 treatment-related deaths in the chemotherapy-plus-bevacizumab group, including 5 from pulmonary hemorrhage. Conclusions The addition of bevacizumab to paclitaxel plus carboplatin in the treatment of selected patients with non–small-cell lung cancer has a significant survival benefit with the risk of increased treatment-related deaths. (ClinicalTrials.gov number, NCT00021060.)