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Long-Hao Xu

Publications and source records attributed to Long-Hao Xu.

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Subgroup analysis in randomized controlled trials with binary outcomes: dilution and logic-respecting properties

Subgroup analysis is routinely used in randomized controlled trials to examine whether treatment effects are homogeneous across patient subgroups or differ because of treatment-effect heterogeneity. In this paper, we investigate the properties of the odds ratio and the relative response in subgroup analyses with binary outcomes, extending previous work with new theoretical insights and methodological developments. We establish several new theorems that characterize how the odds ratio for the overall population changes in both magnitude and direction when two subgroups are combined. These results further confirm that the odds ratio is inappropriate as an efficacy measure in this subgroup setting, whereas the relative response is appropriate. We also present the formal relationship between the odds ratio and the relative response, and clarify their differences in terms of the logic-respecting property, that is, whether the overall efficacy lies between the subgroup efficacies, and the dilution property, that is, whether mixing subgroups moves the overall odds ratio toward 1. Although the odds ratio is generally not logic-respecting, it may behave approximately like a logic-respecting efficacy measure under certain conditions. To illustrate our findings, we present an illustrative example based on clinical trial data and discuss its implications for subgroup analysis in randomized controlled trials.

stat.ME

A note on blinded continuous monitoring for continuous outcomes

Continuous monitoring is becoming more popular due to its significant benefits, including reducing sample sizes and reaching earlier conclusions. In general, it involves monitoring nuisance parameters (e.g., the variance of outcomes) until a specific condition is satisfied. The blinded method, which does not require revealing group assignments, was recommended because it maintains the integrity of the experiment and mitigates potential bias. Although Friede and Miller (2012) investigated the characteristics of blinded continuous monitoring through simulation studies, its theoretical properties are not fully explored. In this paper, we aim to fill this gap by presenting the asymptotic and finite-sample properties of the blinded continuous monitoring for continuous outcomes. Furthermore, we examine the impact of using blinded versus unblinded variance estimators in the context of continuous monitoring. Simulation results are also provided to evaluate finite-sample performance and to support the theoretical findings.

math.ST

A studentized permutation test for the treatment effect in individual participant data meta-analysis

Meta-analysis is a well-established tool used to combine data from several independent studies, each of which usually compares the effect of an experimental treatment with a control group. While meta-analyses are often performed using aggregated study summaries, they may also be conducted using individual participant data (IPD). Classical meta-analysis models may be generalized to handle continuous IPD by formulating them within a linear mixed model framework. IPD meta-analyses are commonly based on a small number of studies. Technically, inference for the overall treatment effect can be performed using Student-t approximation. However, as some approaches may not adequately control the type I error, Satterthwaite's or Kenward-Roger's method have been suggested to set the degrees-of-freedom parameter. The latter also adjusts the standard error of the treatment effect estimator. Nevertheless, these methods may be conservative. Since permutation tests are known to control the type I error and offer robustness to violations of distributional assumptions, we propose a studentized permutation test for the treatment effect based on permutations of standardized residuals across studies in IPD meta-analysis. Also, we construct confidence intervals for the treatment effect based on this test. The first interval is derived from the percentiles of the permutation distribution. The second interval is obtained by searching values closest to the effect estimate that are just significantly different from the true effect. In a simulation study, we demonstrate satisfactory performance of the proposed methods, often producing shorter confidence intervals compared with competitors.

stat.ME

A studentized permutation test in group sequential designs

In group sequential designs, where several data looks are conducted for early stopping, we generally assume the vector of test statistics from the sequential analyses follows (at least approximately or asymptotially) a multivariate normal distribution. However, it is well-known that test statistics for which an asymptotic distribution is derived may suffer from poor small sample approximation. This might become even worse with an increasing number of data looks. The aim of this paper is to improve the small sample behaviour of group sequential designs while maintaining the same asymptotic properties as classical group sequential designs. This improvement is achieved through the application of a modified permutation test. In particular, this paper shows that the permutation distribution approximates the distribution of the test statistics not only under the null hypothesis but also under the alternative hypothesis, resulting in an asymptotically valid permutation test. An extensive simulation study shows that the proposed permutation test better controls the Type I error rate than its competitors in the case of small sample sizes.

math.ST