Improving efficiency in clinical trials using auxiliary information: Application of a multi-state cure model

A. S C Conlon, J. M G Taylor, D. J. Sargent

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

In clinical trials, an intermediate marker measured after randomization can often provide early information about the treatment effect on the final outcome of interest. We explore the use of recurrence time as an auxiliary variable for estimating the treatment effect on overall survival in phase three randomized trials of colon cancer. A multi-state model with an incorporated cured fraction for recurrence is used to jointly model time to recurrence and time to death. We explore different ways in which the information about recurrence time and the assumptions in the model can lead to improved efficiency. Estimates of overall survival and disease-free survival can be derived directly from the model with efficiency gains obtained as compared to Kaplan-Meier estimates. Alternatively, efficiency gains can be achieved by using the model in a weaker way in a multiple imputation procedure, which imputes death times for censored subjects. By using the joint model, recurrence is used as an auxiliary variable in predicting survival times. We demonstrate the potential use of the proposed methods in shortening the length of a trial and reducing sample sizes.

Original languageEnglish (US)
Pages (from-to)460-468
Number of pages9
JournalBiometrics
Volume71
Issue number2
DOIs
StatePublished - Jun 1 2015

Fingerprint

Cure Model
Multi-state Model
Auxiliary Information
Clinical Trials
Recurrence
clinical trials
Auxiliary Variables
Treatment Effects
Kaplan-Meier Estimate
Randomized Trial
Multiple Imputation
Joint Model
death
Survival Time
Randomisation
Model
Random Allocation
colorectal neoplasms
Cancer
Sample Size

Keywords

  • Auxiliary variable
  • Colon cancer
  • Cure models
  • Multi-state model
  • Multiple imputation

ASJC Scopus subject areas

  • Applied Mathematics
  • Statistics and Probability
  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)
  • Medicine(all)

Cite this

Improving efficiency in clinical trials using auxiliary information : Application of a multi-state cure model. / Conlon, A. S C; Taylor, J. M G; Sargent, D. J.

In: Biometrics, Vol. 71, No. 2, 01.06.2015, p. 460-468.

Research output: Contribution to journalArticle

Conlon, A. S C ; Taylor, J. M G ; Sargent, D. J. / Improving efficiency in clinical trials using auxiliary information : Application of a multi-state cure model. In: Biometrics. 2015 ; Vol. 71, No. 2. pp. 460-468.
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