Showing papers in "Biometrics in 1999"

Genomic control for association studies.

Abstract: A dense set of single nucleotide polymorphisms (SNP) covering the genome and an efficient method to assess SNP genotypes are expected to be available in the near future. An outstanding question is how to use these technologies efficiently to identify genes affecting liability to complex disorders. To achieve this goal, we propose a statistical method that has several optimal properties: It can be used with case control data and yet, like family-based designs, controls for population heterogeneity; it is insensitive to the usual violations of model assumptions, such as cases failing to be strictly independent; and, by using Bayesian outlier methods, it circumvents the need for Bonferroni correction for multiple tests, leading to better performance in many settings while still constraining risk for false positives. The performance of our genomic control method is quite good for plausible effects of liability genes, which bodes well for future genetic analyses of complex disorders.

Finite Mixture Modeling with Mixture Outcomes Using the EM Algorithm

Abstract: Summary. This paper discusses the analysis of an extended finite mixture model where the latent classes corresponding to the mixture components for one set of observed variables influence a second set of observed variables. The research is motivated by a repeated measurement study using a random coefficient model to assess the influence of latent growth trajectory class membership on the probability of a binary disease outcome. More generally, this model can be seen as a combination of latent class modeling and conventional mixture modeling. The EM algorithm is used for estimation. As an illustration, a random-coefficient growth model for the prediction of alcohol dependence from three latent classes of heavy alcohol use trajectories among young adults is analyzed.

Predictive margins with survey data.

Abstract: In the analysis of covariance, the display of adjusted treatment means allows one to compare mean (treatment) group outcomes controlling for different covariate distributions in the groups. Predictive margins are a generalization of adjusted treatment means to nonlinear models. The predictive margin for group r represents the average predicted response if everyone in the sample had been in group r. This paper discusses the use of predictive margins with complex survey data, where an important consideration is the choice of covariate distribution used to standardize the predictive margin. It is suggested that the textbook formula for the standard error of an adjusted treatment mean from the analysis of covariance may be inappropriate for applications involving survey data. Applications are given using data from the 1992 National Health Interview Survey (NHIS) and the Epidemiologic Followup Study to the first National Health and Nutrition Examination Survey (NHANES I).

Adaptive sample size calculations in group sequential trials.

Abstract: A method for group sequential trials that is based on the inverse normal method for combining the results of the separate stages is proposed. Without exaggerating the Type I error rate, this method enables data-driven sample size reassessments during the course of the study. It uses the stopping boundaries of the classical group sequential tests. Furthermore, exact test procedures may be derived for a wide range of applications. The procedure is compared with the classical designs in terms of power and expected sample size.

Bayesian phylogenetic inference via Markov chain Monte Carlo methods.

Abstract: We derive a Markov chain to sample from the posterior distribution for a phylogenetic tree given sequence information from the corresponding set of organisms, a stochastic model for these data, and a prior distribution on the space of trees. A transformation of the tree into a canonical cophenetic matrix form suggests a simple and effective proposal distribution for selecting candidate trees close to the current tree in the chain. We illustrate the algorithm with restriction site data on 9 plant species, then extend to DNA sequences from 32 species of fish. The algorithm mixes well in both examples from random starting trees, generating reproducible estimates and credible sets for the path of evolution.

Modification of Sample Size in Group Sequential Clinical Trials

Abstract: In group sequential clinical trials, sample size reestimation can be a complicated issue when it allows for change of sample size to be influenced by an observed sample path. Our simulation studies show that increasing sample size based on an interim estimate of the treatment difference can substantially inflate the probability of type I error in most practical situations. A new group sequential test procedure is developed by modifying the weights used in the traditional repeated significance two-sample mean test. The new test has the type I error probability preserved at the target level and can provide a substantial gain in power with the increase of sample size. Generalization of the new procedure is discussed.

A general maximum likelihood analysis of variance components in generalized linear models.

Abstract: This paper describes an EM algorithm for nonparametric maximum likelihood (ML) estimation in generalized linear models with variance component structure. The algorithm provides an alternative analysis to approximate MQL and PQL analyses (McGilchrist and Aisbett, 1991, Biometrical Journal 33, 131-141; Breslow and Clayton, 1993; Journal of the American Statistical Association 88, 9-25; McGilchrist, 1994, Journal of the Royal Statistical Society, Series B 56, 61-69; Goldstein, 1995, Multilevel Statistical Models) and to GEE analyses (Liang and Zeger, 1986, Biometrika 73, 13-22). The algorithm, first given by Hinde and Wood (1987, in Longitudinal Data Analysis, 110-126), is a generalization of that for random effect models for overdispersion in generalized linear models, described in Aitkin (1996, Statistics and Computing 6, 251-262). The algorithm is initially derived as a form of Gaussian quadrature assuming a normal mixing distribution, but with only slight variation it can be used for a completely unknown mixing distribution, giving a straightforward method for the fully nonparametric ML estimation of this distribution. This is of value because the ML estimates of the GLM parameters can be sensitive to the specification of a parametric form for the mixing distribution. The nonparametric analysis can be extended straightforwardly to general random parameter models, with full NPML estimation of the joint distribution of the random parameters. This can produce substantial computational saving compared with full numerical integration over a specified parametric distribution for the random parameters. A simple method is described for obtaining correct standard errors for parameter estimates when using the EM algorithm. Several examples are discussed involving simple variance component and longitudinal models, and small-area estimation.

Population HIV-1 dynamics in vivo: applicable models and inferential tools for virological data from AIDS clinical trials.

Abstract: In this paper, we introduce a novel application of hierarchical nonlinear mixed-effect models to HIV dynamics. We show that a simple model with a sum of exponentials can give a good fit to the observed clinical data of HIV-1 dynamics (HIV-1 RNA copies) after initiation of potent antiviral treatments and can also be justified by a biological compartment model for the interaction between HIV and its host cells. This kind of model enjoys both biological interpretability and mathematical simplicity after reparameterization and simplification. A model simplification procedure is proposed and illustrated through examples. We interpret and justify various simplified models based on clinical data taken during different phases of viral dynamics during antiviral treatments. We suggest the hierarchical nonlinear mixed-effect model approach for parameter estimation and other statistical inferences. In the context of an AIDS clinical trial involving patients treated with a combination of potent antiviral agents, we show how the models may be used to draw biologically relevant interpretations from repeated HIV-1 RNA measurements and demonstrate the potential use of the models in clinical decision-making.

Estimating intraclass correlation for binary data.

Abstract: This paper reviews many different estimators of intraclass correlation that have been proposed for binary data and compares them in an extensive simulation study. Some of the estimators are very specific, while others result from general methods such as pseudo-likelihood and extended quasi-likelihood estimation. The simulation study identifies several useful estimators, one of which does not seem to have been considered previously for binary data. Estimators based on extended quasi-likelihood are found to have a substantial bias in some circumstances.

Test-based exact confidence intervals for the difference of two binomial proportions.

Abstract: Confidence intervals are often provided to estimate a treatment difference. When the sample size is small, as is typical in early phases of clinical trials, confidence intervals based on large sample approximations may not be reliable. In this report, we propose test-based methods of constructing exact confidence intervals for the difference in two binomial proportions. These exact confidence intervals are obtained from the unconditional distribution of two binomial responses, and they guarantee the level of coverage. We compare the performance of these confidence intervals to ones based on the observed difference alone. We show that a large improvement can be achieved by using the standardized Z test with a constrained maximum likelihood estimate of the variance.

Mixed effects models with censored data with application to HIV RNA levels.

Abstract: Summary. Mixed effects models are often used for estimating fixed effects and variance components in longitudinal studies of continuous data. When the outcome being modelled is a laboratory measurement, however, it may be subject to lower and upper detection limits (i.e., censoring). In this paper, the usual EM estimation procedure for mixed effects models is modified to account for left and/or right censoring.

Marginally specified logistic-normal models for longitudinal binary data.

Abstract: Summary. Likelihood-based inference for longitudinal binary data can be obtained using a generalized linear mixed model (Breslow, N. and Clayton, D. G., 1993, Journal of the American Statistical Association88, 9–25; Wolfinger, R. and O'Connell, M., 1993, Journal of Statistical Computation and Simulation48, 233–243), given the recent improvements in computational approaches. Alternatively, Fitzmaurice and Laird (1993, Biometrika80, 141–151), Molenberghs and Lesaffre (1994, Journal of the American Statistical Association89, 633–644), and Heagerty and Zeger (1996, Journal of the American Statistical Association91, 1024–1036) have developed a likelihood-based inference that adopts a marginal mean regression parameter and completes full specification of the joint multivariate distribution through either canonical and/or marginal higher moment assumptions. Each of these marginal approaches is computationally intense and currently limited to small cluster sizes. In this manuscript, an alternative parameterization of the logistic-normal random effects model is adopted, and both likelihood and estimating equation approaches to parameter estimation are studied. A key feature of the proposed approach is that marginal regression parameters are adopted that still permit individual-level predictions or contrasts. An example is presented where scientific interest is in both the mean response and the covariance among repeated measurements.

TestâBased Exact Confidence Intervals for the Difference of Two Binomial Proportions

Abstract: Confidence intervals are often provided to estimate a treatment difference. When the sample size is small, as is typical in early phases of clinical trials, confidence intervals based on large sample approximations may not be reliable. In this report, we propose test‐based methods of constructing exact confidence intervals for the difference in two binomial proportions. These exact confidence intervals are obtained from the unconditional distribution of two binomial responses, and they guarantee the level of coverage. We compare the performance of these confidence intervals to ones based on the observed difference alone. We show that a large improvement can be achieved by using the standardized Z test with a constrained maximum likelihood estimate of the variance.

The use of mixed logit models to reflect heterogeneity in capture-recapture studies.

Abstract: We examine issues in estimating population size N with capture-recapture models when there is variable catchability among subjects. We focus on a logistic-normal mixed model, for which the logit of the probability of capture is an additive function of a random subject and a fixed sampling occasion parameter. When the probability of capture is small or the degree of heterogeneity is large, the log-likelihood surface is relatively flat and it is difficult to obtain much information about N. We also discuss a latent class model and a log-linear model that account for heterogeneity and show that the log-linear model has greater scope. Models assuming homogeneity provide much narrower intervals for N but are usually highly overly optimistic, the actual coverage probability being much lower than the nominal level.

The Knox method and other tests for space-time interaction.

Abstract: Summary. The Knox method, as well as other tests for space-time interaction, are biased when there are geographical population shifts, i.e., when there are different percent population growths in different regions. In this paper, the size of the population shift bias is investigated for the Knox test, and it is shown that it can be a considerable problem. A Monte Carlo method for constructing unbiased space-time interaction tests is then presented and illustrated on the Knox test as well as for a combined Knox test. Practical implications are discussed in terms of the interpretation of past results and the design of future studies.

Valid inference in random effects meta-analysis

Abstract: The standard approach to inference for random effects meta-analysis relies on approximating the null distribution of a test statistic by a standard normal distribution. This approximation is asymptotic on k, the number of studies, and can be substantially in error in medical meta-analyses, which often have only a few studies. This paper proposes permutation and ad hoc methods for testing with the random effects model. Under the group permutation method, we randomly switch the treatment and control group labels in each trial. This idea is similar to using a permutation distribution for a community intervention trial where communities are randomized in pairs. The permutation method theoretically controls the type I error rate for typical meta-analyses scenarios. We also suggest two ad hoc procedures. Our first suggestion is to use a t-reference distribution with k-1 degrees of freedom rather than a standard normal distribution for the usual random effects test statistic. We also investigate the use of a simple t-statistic on the reported treatment effects.

A Bayesian semiparametric accelerated failure time model.

Abstract: A Bayesian semiparametric approach is described for an accelerated failure time model. The error distribution is assigned a Polya tree prior and the regression parameters a noninformative hierarchical prior. Two cases are considered: the first assumes error terms are exchangeable; the second assumes that error terms are partially exchangeable. A Markov chain Monte Carlo algorithm is described to obtain a predictive distribution for a future observation given both uncensored and censored data.

Fundamentals of Survival Data

Abstract: Survival data stand out as a special statistical field. This paper tries to describe what survival data is and what makes it so special. Survival data concern times to some events. A key point is the successive observation of time, which on the one hand leads to some times not being observed so that all that is known is that they exceed some given times (censoring), and on the other hand implies that predictions regarding the future course should be conditional on the present status (truncation). In the simplest case, this condition is that the individual is alive. The successive conditioning makes the hazard function, which describes the probability of an event happening during a short interval given that the individual is alive today (or more generally able to experience the event), the most relevant concept. Standard distributions available (normal, log-normal, gamma, inverse Gaussian, and so forth) can account for censoring and truncation, but this is cumbersome. Besides, they fit badly because they are either symmetric or right skewed, but survival time distributions can easily be left-skewed positive variables. A few distributions satisfying these requirements are available, but often nonparametric methods are preferable as they account better conceptually for truncation and censoring and give a better fit. Finally, we compare the proportional hazards regression models with accelerated failure time models.

Monte Carlo EM for missing covariates in parametric regression models.

Abstract: We propose a method for estimating parameters for general parametric regression models with an arbitrary number of missing covariates. We allow any pattern of missing data and assume that the missing data mechanism is ignorable throughout. When the missing covariates are categorical, a useful technique for obtaining parameter estimates is the EM algorithm by the method of weights proposed in Ibrahim (1990, Journal of the American Statistical Association85, 765–769). We extend this method t o continuous or mixed categorical and continuous covariates, and for arbitrary parametric regression models, by adapting a Monte Carlo version of the EM algorithm as discussed by Wei and Tanner (1990, Journal of the American Statistical Association85, 699–704). In addition, we discuss the Gibbs sampler for sampling from the conditional distribution of the missing covariates given the observed data and show that the appropriate complete conditionals are log‐concave. The log‐concavity property of the conditional distributions will facilitate a straightforward implementation of the Gibbs sampler via the adaptive rejection algorithm of Gilks and Wild (1992, Applied Statistics41, 337–348). We assume the model for the response given the covariates is an arbitrary parametric regression model, such as a generalized linear model, a parametric survival model, or a nonlinear model. We model the marginal distribution of the covariates as a product of one‐dimensional conditional distributions. This allows us a great deal of flexibility in modeling the distribution of the covariates and reduces the number of nuisance parameters that are introduced in the E‐step. We present examples involving both simulated and real data.

Statistical inference for self-designing clinical trials with a one-sided hypothesis

Abstract: In the process of monitoring clinical trials, it seems appealing to use the interim findings to determine whether the sample size originally planned will provide adequate power when the alternative hypothesis is true, and to adjust the sample size if necessary. In the present paper, we propose a flexible sequential monitoring method following the work of Fisher (1998), in which the maximum sample size does not have to be specified in advance. The final test statistic is constructed based on a weighted average of the sequentially collected data, where the weight function at each stage is determined by the observed data prior to that stage. Such a weight function is used to maintain the integrity of the variance of the final test statistic so that the overall type I error rate is preserved. Moreover, the weight function plays an implicit role in termination of a trial when a treatment difference exists. Finally, the design allows the trial to be stopped early when the efficacy result is sufficiently negative. Simulation studies confirm the performance of the method.

Bayesian design and analysis of active control clinical trials.

Abstract: We consider the design and analysis of active control clinical trials, i.e., clinical trials comparing an experimental treatment E to a control treatment C considered to be effective. Direct comparison of E to placebo P, or no treatment, is sometimes ethically unacceptable. Much discussion of the design and analysis of such clinical trials has focused on whether the comparison of E to C should be based on a test of the null hypothesis of equivalence, on a test of a nonnull hypothesis that the difference is of some minimally medically important size delta, or on one or two-sided confidence intervals. These approaches are essentially the same for study planning. They all suffer from arbitrariness in specifying the size of the difference delta that must be excluded. We propose an alternative Bayesian approach to the design and analysis of active control trials. We derive the posterior probability that E is superior to P or that E is at least k% as good as C and that C is more effective than P. We also derive approximations for use with logistic and proportional hazard models. Selection of prior distributions is discussed, and results are illustrated using data from an active control trial of a drug for the treatment of unstable angina.

Flexible parametric measurement error models.

Abstract: Inferences in measurement error models can be sensitive to modeling assumptions. Specifically, if the model is incorrect, the estimates can be inconsistent. To reduce sensitivity to modeling assumptions and yet still retain the efficiency of parametric inference, we propose using flexible parametric models that can accommodate departures from standard parametric models. We use mixtures of normals for this purpose. We study two cases in detail: a linear errors-in-variables model and a change-point Berkson model.

Nonparametric Estimation of a Delay Distribution Based on Left-Censored and Right-Truncated Data

Abstract: This paper proposes a nonparametric method for estimating a delay distribution based on left-censored and right-truncated data. A variance-covariance estimator is provided. The method is applied to the Australian AIDS data in which some data are left censored and some data are not left censored. This situation arises with AIDS case-reporting data in Australia because reporting delays were recorded only from November 1990 rather than from the beginning of the epidemic there. It is shown that inclusion of the left-censored data, as opposed to analyzing only the uncensored data, improves the precision of the estimate.

An Empirical Comparison of Several Clustered Data Approaches Under Confounding Due to Cluster Effects in the Analysis of Complications of Coronary Angioplasty

Abstract: Summary. In the analysis of binary response data from many types of large studies, the data are likely to have arisen from multiple centers, resulting in a within-center correlation for the response. Such correlation, or clustering, occurs when outcomes within centers tend to be more similar to each other than to outcomes in other centers. In studies where there is also variability among centers with respect to the exposure of interest, analysis of the exposure–outcome association may be confounded, even after accounting for within-center correlations. We apply several analytic methods to compare the risk of major complications associated with two strategies, staged and combined procedures, for performing percutaneous transluminal coronary angioplasty (PTCA), a mechanical means of relieving blockage of blood vessels due to atherosclerosis. Combined procedures are used in some centers as a cost-cutting strategy. We performed a number of population-averaged and cluster-specific (conditional) analyses, which (a) make no adjustments for center effects of any kind; (b) make adjustments for the effect of center on only the response; or (c) make adjustments for both the effect of center on the response and the relationship between center and exposure. The method used for this third approach decomposes the procedure type variable into within-center and among-center components, resulting in two odds ratio estimates. The naive analysis, ignoring clusters, gave a highly significant effect of procedure type (OR = 1.6). Population average models gave marginally to very non significant estimates of the OR for treatment type ranging from 1.6 to 1.2 with adjustment only for the effect of centers on response. These results depended on the assumed correlation structure. Conditional (cluster-specific) models and other methods that decomposed the treatment type variable into among- and within-center components all found no within-center effect of procedure type (OR = 1.02, consistently) and a considerable among-center effect. This among-center variability in outcomes was related to the proportion of patients who receive combined procedures and was found even when conditioned on procedure type (within-center) and other patient- and center-level covariates. This example illustrates the importance of addressing the potential for center effects to confound an outcome-exposure association when average exposure varies across clusters. While conditional approaches provide estimates of the within-cluster effect, they do not provide information about among-center effects. We recommend using the decomposition approach, as it provides both types of estimates.

Comparison of several independent population means when their samples contain log-normal and possibly zero observations.

Abstract: Summary. In this paper, we consider the problem of testing the mean equality of several independent populations that contain log-normal and possibly zero observations. We first showed that the currently used methods in statistical practice, including the nonparametric Kruskal–Wallis test, the standard ANOVA F-test and its two modified versions, the Welch test and the Brown–Forsythe test, could have poor Type I error control. Then we propose a likelihood ratio test that is shown to have much better Type I error control than the existing methods. Finally, we analyze two real data sets that motivated our study using the proposed test.

On logit confidence intervals for the odds ratio with small samples.

Abstract: Unless the true association is very strong, simple large-sample confidence intervals for the odds ratio based on the delta method perform well even for small samples. Such intervals include the Woolf logit interval and the related Gart interval based on adding .5 before computing the log odds ratio estimate and its standard error. The Gart interval smooths the observed counts toward the model of equiprobability, but one obtains better coverage probabilities by smoothing toward the independence model and by extending the interval in the appropriate direction when a cell count is zero.

A Unifying Family of Group Sequential Test Designs

Abstract: Summary. Currently, the design of group sequential clinical trials requires choosing among several distinct design categories, design scales, and strategies for determining stopping rules. This approach can limit the design selection process so that clinical issues are not fully addressed. This paper describes a family of designs that unifies previous approaches and allows continuous movement among the previous categories. This unified approach facilitates the process of tailoring the design to address important clinical issues. The unified family of designs is constructed from a generalization of a four-boundary group sequential design in which the shape and location of each boundary can be independently specified. Methods for implementing the design using error-spending functions are described. Examples illustrating the use of the design family are also presented.

Bayesian analysis and model selection for interval-censored survival data.

Abstract: Summary. Interval-censored data occur in survival analysis when the survival time of each patient is only known to be within an interval and these censoring intervals differ from patient to patient. For such data, we present some Bayesian discretized semiparametric models, incorporating proportional and nonproportional hazards structures, along with associated statistical analyses and tools for model selection using sampling-based methods. The scope of these methodologies is illustrated through a reanalysis of a breast cancer data set (Finkelstein, 1986, Biometrics42, 845–854) to test whether the effect of covariate on survival changes over time.

Likelihood models for clustered binary and continuous outcomes: application to developmental toxicology.

Abstract: Summary. In developmental toxicology, methods based on dose-response modeling and quantitative risk assessment are being actively pursued. Among live fetuses, the presence of malformations and reduction in fetal weight are of primary interest, but ordinarily, the dose-response relationships are characterized in each of the outcomes separately while appropriately accounting for clustering within litters. Jointly modeling the outcomes, allowing different relationships with dose while incorporating the correlation between the fetuses and the outcomes, may be more appropriate. We propose a likelihood-based model that is an extension of a correlated probit model to incorporate continuous outcomes. Our model maintains a marginal dose–response interpretation for the individual outcomes while taking into account both the correlations between outcomes on an individual fetus and those due to clustering. The joint risk of malformation and low birth weight can then be estimated directly. This approach is particularly well suited to estimating safe dose levels as part of quantitative risk assessment.

A penalized likelihood approach for a progressive three-state model with censored and truncated data: application to AIDS.

Abstract: Summary. We consider the estimation of the intensity and survival functions for a continuous time progressive three-state semi-Markov model with intermittently observed data. The estimator of the intensity function is defined nonparametrically as the maximum of a penalized likelihood. We thus obtain smooth estimates of the intensity and survival functions. This approach can accommodate complex observation schemes such as truncation and interval censoring. The method is illustrated with a study of hemophiliacs infected by HIV. The intensity functions and the cumulative distribution functions for the time to infection and for the time to AIDS are estimated. Covariates can easily be incorporated into the model.