Showing posts with label probability. Show all posts
Showing posts with label probability. Show all posts

9/07/2012

Design and Analysis of Clinical Trials with Time-to-Event Endpoints (Chapman & Hall/CRC Biostatistics Series) Review

Design and Analysis of Clinical Trials with Time-to-Event Endpoints (Chapman and Hall/CRC Biostatistics Series)
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Often in clinical trials particularly oncology trials time-to-event are the endpoints of primary interest. The endpoint could be time of death, time to remittance, time to recurrence or something else. In the recent RE-LY trial which was a stroke prevention trial the dual primary endpoints were time-to-an-occurrence of stroke and time-to-a-major bleeding episode. It seems almost always the case that the study will involved estimating these parameters based on data the include a lot of right-censoring. So the methods of survival or relaibility analysis come to play an imprtant role. Usually if the events are rare the sample size requirement will be large because power of the test of differences between two groups is dictated by the number of events which then requires large sample size s to achieve the requisite number of events. The RE-LY trial was a noninferiority trial with three equal size treatment arms and rare event occurrences. So thid trial required approximately 18000 subjects with 600 in each group. Such trials are long, difficult to administer and very expensive. So often the time-to-event endpoint is replaced by a surrogate endpoint.
Karl Peace has edited and contributed to a very timely volume on the design and analysis of time-to-event endpoints in clinical trials. This book can serve as a text or a reference for biostatisticians and particularly those involved in clinical trials, especially oncology trials. A number of authors with a lot of experience with such trials were chosen to contribute to this volume. The first 6 chapters are introductory and mostly overviews of a particular methodology. Chapter 1 by Peace,is a general overview of the topic and an introdcution to what is included in the remaining chapters. Chapter 2 by Sill and Rubinstein introduces how time-to-event endpoint trials are designed and monitored. Chapter 3 is an overview of parametric models for time-to-event distrbution by Peace and Tsai. Chapter 4 does the same for semiparametric methods (the Cox proportional hazard model and its extensions) Chapter 5 is an overview of methods to handle categorical time-to-event data. Chapters 6 and 9 cover overviews of Bayesian methods applied to time-to-event data and graphical approaches respectively. These chapters read like they are part of an introductory text and they have large reference lists for very pertinent and up-to-date articles and books. The other chapters are mostly specialized topics such as chapter 8 by Bhore and Huque on the estimation and and testing of a change in the hazard rate in the survival curve.
I particularly like the book because it provides a refresher course that also includes new approaches or old ones that I am not so familiar with. It is a very important and authoritative text that any statistician doing time-to-event trials can rely on.

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Using time-to-event analysis methodology requires careful definition of the event, censored observation, provision of adequate follow-up, number of events, and independence or "noninformativeness" of the censoring mechanisms relative to the event. Design and Analysis of Clinical Trials with Time-to-Event Endpoints provides a thorough presentation of the design, monitoring, analysis, and interpretation of clinical trials in which time-to-event is of critical interest.After reviewing time-to-event endpoint methodology, clinical trial issues, and the design and monitoring of clinical trials, the book focuses on inferential analysis methods, including parametric, semiparametric, categorical, and Bayesian methods; an alternative to the Cox model for small samples; and estimation and testing for change in hazard. It then presents descriptive and graphical methods useful in the analysis of time-to-event endpoints. The next several chapters explore a variety of clinical trials, from analgesic, antibiotic, and antiviral trials to cardiovascular and cancer prevention, prostate cancer, astrocytoma brain tumor, and chronic myelogonous leukemia trials. The book then covers areas of drug development, medical practice, and safety assessment. It concludes with the design and analysis of clinical trials of animals required by the FDA for new drug applications.Drawing on the expert contributors' experiences working in biomedical research and clinical drug development, this comprehensive resource covers an array of time-to-event methods and explores an assortment of real-world applications.

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4/09/2012

Primer of Applied Regression & Analysis of Variance Review

Primer  of Applied Regression and Analysis of Variance
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Like all advanced stats books, this one has mathematical rigor and plenty of examples. But unlike the others, this one is written from the point of view of a biologist. You won't just learn the math, you'll learn how to make sense of the results. The title is a bit misleading. This is not a "primer" of statistics. But once you've learned the basic principles of statistics, this is THE book to learn about various kinds of ANOVAS and regressions.

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Applicable for all statistics courses or practical use, teaches how to understand more advanced multivariate statistical methods, as well as how to use available software packages to get correct results. Study problems and examples culled from biomedical research illustrate key points. New to this edition: broadened coverage of ANOVA (traditional analysis of variance), the addition of ANCOVA (analysis of Co-Variance); updated treatment of available statistics software; 2 new chapters (Analysis of Variance Extensions and Mixing Regression and ANOVA: ANCOVA). (20010101)

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2/12/2012

Modeling in Medical Decision Making: A Bayesian Approach (Statistics in Practice) Review

Modeling in Medical Decision Making: A Bayesian Approach (Statistics in Practice)
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This is a nice readable book about decision theory from the Bayesian perspective. In addition to providing the foundations of Bayesian decision theory including utility theory the author prvides many real world research examples including meta-analyses.
Unlike his more recent and highly statistically sophisticated text on Bayesian decision theory this concentrates on medical examples and his written at a level to appeal to clinicians as well as statisticians. Decision trees and methods toevaluate quality of life years are introduced and used in the examples.

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1/09/2012

Handbook of Statistics, Volume 27: Epidemiology and Medical Statistics Review

Handbook of Statistics, Volume 27: Epidemiology and Medical Statistics
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This series is a long and successful collection of volumes on the most important topics in statistics. Professor Krishnaiah from the University of Pittsburgh was one of the first editors. When the famous Professor C. R. Rao moved from India to the US he joined his colleague Krishnaiah at Pittsburgh and helped coedit some of these handbooks. After Krishnaiah's death Professor Rao continued to edit these volumes and brought in some of his colleagues as co-editors.
This is volume 27 and it contains 27 chapters on the topic of medical statistics and epidemiology. This is very important to me as I work in the medical research area.
The editors have assembly the leading experts in statistical methodology and applied biostatistical reserach to produce these 27 chapters.
Ross Prentice (coauthor of 2 edition of a book on survival analysis and the Cox model) wrote an overview chapter on the topics to be covered. He has had a long career at the Fred Hutchinson Cancer Research Center in Seattle Washington. Fred Hutchinson was a famous manager for the Cincinnati Reds in the early 1960s and brought them to the World Series in 1961. He died of cancer and his estate started an endowment to form this research center.
Don Rubin covers causal analysis in Chapter 2. Rubin is an expert on causal inference, Bayesian methods and missing data. He presents the randomized trial approaches of Fisher and Neyman introduces propensity scores. A Bayesian approach is also covered.
Other chapters cover epidemiologic study designs, assessments for biomarkers, linear and nonlinear regression models, logistic regression, regression models for count data, mixed linear and nonlinear models, survival analysis, competing risk models, cluster analysis, factor analysis, structural equation models, crossover trials, group sequential methods, early phase trials (I and II), late phase (III and IV), missing data, Meta-Analysis, multiple comparisons, sample size determination
statistical learning using splines, evidence based medicine, marginal regression models, use of difference equations in modeling and the Bayesian approach to medical inference.
This volume is over 800 pages and each chapter is fairly long and includes large bibliographies.

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11/13/2011

Practical Statistics for Medical Research (Chapman & Hall/CRC Texts in Statistical Science) Review

Practical Statistics for Medical Research (Chapman and Hall/CRC Texts in Statistical Science)
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This is a very well written and popular text on biostatistics. Altman writes for non-statisticians but the book is best suited for those with at least one prior course in statistics and those who have had mathematics through high school algebra. Emphasis is placed on the important practical problems. Good statistical designs and analyses are emphasized. The pitfalls with many published medical articles are discussed in Chapter 16.
I used this book to teach a 20 lecture course to students (engineers, clinicians and computer scientists) at Pacesetter in 1998 and at Biosense Webster in 1999 (both medical device companies that employed me as senior biostatistician). It was a good refresher course for the CRAs and engineers and it helped to make it easier for me to work with them on their statistical problems.
I have also taught a similar course to undergraduate students in the Health Science Department at Cal State Long Beach. Altman's book is a little too advanced to use as a text for that course but I did use it as a reference and covered material in Chapter 16 at the end of the course. Clear discussion of the medical literature is very important to these students and Altman does a great job!


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Most medical researchers, whether clinical or non-clinical, receive some background in statistics as undergraduates. However, it is most often brief, a long time ago, and largely forgotten by the time it is needed. Furthermore, many introductory texts fall short of adequately explaining the underlying concepts of statistics, and often are divorced from the reality of conducting and assessing medical research.Practical Statistics for Medical Research is a problem-based text for medical researchers, medical students, and others in the medical arena who need to use statistics but have no specialized mathematics background. The author draws on twenty years of experience as a consulting medical statistician to provide clear explanations to key statistical concepts, with a firm emphasis on practical aspects of designing and analyzing medical research. The text gives special attention to the presentation and interpretation of results and the many real problems that arise in medical research.

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