Sample size determination for a matched-pairs study with incomplete data using exact approach

Efficient statistical inference for a parallel study with missing data by using an exact method

In a parallel group study comparing a new treatment with a standard of care, missing data often occur for various reasons. When the outcome is binary, the data from such studies can be summarized into a 2 × 3 contingency table, with the missing observations in the last column. When the missingness is neither related to the outcome of interest nor related to other outcomes from the study but it is covariate dependent with the sole covariate being treatment, this type of missing data mechanism is considered as missing at random. In 2016, Tian et al.  proposed three statistics to test the hypothesis that the response rate is equivalent for a parallel group study with missing data. The asymptotic limiting distributions of these test statistics were used for statistical inference. However, asymptotic approaches for testing proportions generally do not have satisfactory performance with regard to type I error rate control for a clinical trial with the sample size from small to medium. For this reason, we consider an exact approach based on maximization to provide valid and efficient statistical inference for a parallel group study with missing data. Exact approaches can guarantee the type I error rate and they are computationally feasible in this setting. We conduct extensive numerical studies to compare the performance of the exact approach based on the three statistics for a one-sided hypothesis testing problem. We conclude that the exact approach based on the likelihood ratio statistic is more powerful than the exact approach based on the other two statistics. Two real clinical trial data sets are used to illustrate the application of the proposed exact approach.

Exact confidence limits for the probability of response in two-stage designs

In addition to point estimate for the probability of response in a two-stage design (e.g., Simon's two-stage design for a Phase II clinical trial with binary endpoints), confidence limits should be Cute the confidence interval does not guarantee coverage probability in a two-stage setting. The existing exact approach to calculate one-sided limits is based on the overall number of responses to order the sample space. This approach could be conservative because many sample points have the same limits. We propose a new exact one-sided interval based on p-value for the sample space ordering. Exact intervals are computed by using binomial distributions directly, instead of a normal approximation. Both exact intervals preserve the nominal confidence level. The proposed exact interval based on the p-value generally performs better than the other exact interval with regard to expected length and simple average length of confidence intervals. Therefore, the new interval calculation based on p-value is recommended for use in practice.

Accurate unconditional p-values for a two-arm study with binary endpoints

Unconditional exact tests are increasingly used in practice for categorical data to increase the power of a study and to make the data analysis approach being consistent with the study design. In a two-arm study with a binary endpoint, p-value based on the exact unconditional Barnard test is computed by maximizing the tail probability over a nuisance parameter with a range from 0 to 1. The traditional grid search method is able to find an approximate maximum with a partition of the parameter space, but it is not accurate and this approach becomes computationally intensive for a study beyond two groups. We propose using a polynomial method to rewrite the tail probability as a polynomial. The solutions from the derivative of the polynomial contain the solution for the global maximum of the tail probability. We use an example from a double-blind randomized Phase II cancer clinical trial to illustrate the application of the proposed polynomial method to achieve an accurate p-value. We also compare the performance of the proposed method and the traditional grid search method under various conditions. We would recommend using this new polynomial method in computing accurate exact unconditional p-values.

Fisher's exact approach for post hoc analysis of a chi-squared test

This research is motivated by one of our survey studies to assess the potential influence of introducing zebra mussels to the Lake Mead National Recreation Area, Nevada. One research question in this study is to investigate the association between the boating activity type and the awareness of zebra mussels. A chi-squared test is often used for testing independence between two factors with nominal levels. When the null hypothesis of independence between two factors is rejected, we are often left wondering where does the significance come from. Cell residuals, including standardized residuals and adjusted residuals, are traditionally used in testing for cell significance, which is often known as a post hoc test after a statistically significant chi-squared test. In practice, the limiting distributions of these residuals are utilized for statistical inference. However, they may lead to different conclusions based on the calculated p-values, and their p-values could be over- o6r under-estimated due to the unsatisfactory performance of asymptotic approaches with regards to type I error control. In this article, we propose new exact p-values by using Fisher’s approach based on three commonly used test statistics to order the sample space. We theoretically prove that the proposed new exact p-values based on these test statistics are the same. Based on our extensive simulation studies, we show that the existing asymptotic approach based on adjusted residual is often more likely to reject the null hypothesis as compared to the exact approach due to the inflated family-wise error rates as observed. We would recommend the proposed exact p-value for use in practice as a valuable post hoc analysis technique for chi-squared analysis.