arXiv subjects

Joost van Rosmalen

Publications and source records attributed to Joost van Rosmalen.

3 recordsLinked to original sources

arXiv2026

Adaptive clinical trials based on design-optimal e-values with automatic curtailment: An application to single-arm trials with binary data

The e-value is gaining traction as a robust alternative to p-values and Bayes factors for quantifying statistical evidence. e-values are a promising method for adaptive clinical trials due to their anytime-validity: e-values ensure type I error rate control at any stopping time, facilitating repeated interim analyses, complex stopping rules, and valid inference under protocol deviations. The e-value literature focuses mostly on asymptotic optimality; however, sample sizes in clinical trials are often limited. To this end, we investigate e-value-based designs with finite-horizon optimality for single-arm multi-stage clinical trials with binary data. This setting is relevant in early-phase cancer trials, but it also facilitates an accessible introduction to the betting interpretation of e-values, which we use to construct e-values that either (1) maximize statistical power, or (2) minimize the expected sample size, with or without constraints on the minimum power. We construct these designs through (constrained) dynamic programming based on the currently observed e-value, the maximum sample size, and the pre-specified significance level. Using exact calculations, we show that, next to robustness, e-value-based designs can provide competitive operating characteristics to standard (non-)adaptive designs with and without futility stopping and outperform growth-rate-optimal e-values in finite samples. In addition, small e-values automatically indicate trial continuation is futile, e.g., an e-value of zero indicates the impossibility of an efficacy conclusion. Hence, e-value-based designs provide a viable alternative to the current state-of-the-art in single-arm binary trials, warranting extension to other adaptive clinical trial settings such as multi-arm multi-stage and response-adaptive designs.

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arXiv2023

Augmenting treatment arms with external data through propensity-score weighted power-priors: an application in expanded access

The incorporation of "real-world data" to supplement the analysis of trials and improve decision-making has spurred the development of statistical techniques to account for introduced confounding. Recently, "hybrid" methods have been developed through which measured confounding is first attenuated via propensity scores and unmeasured confounding is addressed through (Bayesian) dynamic borrowing. Most efforts to date have focused on augmenting control arms with historical controls. Here we consider augmenting treatment arms through "expanded access", which is a pathway of non-trial access to investigational medicine for patients with seriously debilitating or life-threatening illnesses. Motivated by a case study on expanded access, we developed a novel method (the ProPP) that provides a conceptually simple and easy-to-use combination of propensity score weighting and the modified power prior. Our weighting scheme is based on the estimation of the average treatment effect of the patients in the trial, with the constraint that external patients cannot receive higher weights than trial patients. The causal implications of the weighting scheme and propensity-score integrated approaches in general are discussed. In a simulation study our method compares favorably with existing (hybrid) borrowing methods in terms of precision and type-I error rate. We illustrate our method by jointly analysing individual patient data from the trial and expanded access program for vemurafenib to treat metastatic melanoma. Our method provides a double safeguard against prior-data conflict and forms a straightforward addition to evidence synthesis methods of trial and real-world (expanded access) data.

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arXiv2015

Personalized Screening Intervals for Biomarkers using Joint Models for Longitudinal and Survival Data

Screening and surveillance are routinely used in medicine for early detection of disease and close monitoring of progression. Biomarkers are one of the primarily tools used for these tasks, but their successful translation to clinical practice is closely linked to their ability to accurately predict clinical endpoints during follow-up. Motivated by a study of patients who received a human tissue valve in the aortic position, in this work we are interested in optimizing and personalizing screening intervals for longitudinal biomarker measurements. Our aim in this paper is twofold: First, to appropriately select the model to use at time t, the time point the patient was still event-free, and second, based on this model to select the optimal time point u > t to plan the next measurement. To achieve these two goals we develop measures based on information theory quantities that assess the information we gain for the conditional survival process given the history of the subject that includes both baseline information and his/her accumulated longitudinal measurements.

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