arXiv subjects

Mouna Akacha

Publications and source records attributed to Mouna Akacha.

4 recordsLinked to original sources

arXiv2026

Communicating results in trials with multiple hypotheses or adaptive design features

Over time, clinical trials have increasingly incorporated complex design and analysis elements such as interim analyses, adaptations, multiple endpoints, and sophisticated multiplicity schemes for multiple endpoints and/or treatment arms following the paradigm of frequentist inference. In frequentist clinical trials multiplicity can come from (at least) four sources: multiple looks at the data, multiple endpoints, multiple populations, or multiple treatment comparisons. Normally, Type 1 error control across the multiple hypotheses is implemented to control chance of false positive decisions. To achieve this advanced techniques such as adaptive designs or graphical multiple testing procedures have been developed and are used in the design of clinical trials. However, these methods focus on hypothesis testing while subsequent estimation remains crucial to allow for a benefit-risk assessment and further use of the results by various stakeholders. Through examples, we illustrate challenges in estimation and transparent communication. In general, there are no simple solutions to this conceptual and communicational challenge. The purpose of this paper is to generate awareness of these issues and initiate a discussion about how to address them moving forward.

stat.ME↗

arXiv2026

Statistical Methodology Groups in the Pharmaceutical Industry

Research and Development is the largest budget position in the pharmaceutical industry, with clinical trials being a critical, yet costly and time-consuming component to inform decisions. Beyond drug efficacy, the probability of success and efficiency of research and development are highly dependent on the approaches used for designing, analyzing, and interpreting clinical trials. Deep understanding of statistical methodology and quantitative approaches is therefore essential. Consequently, dedicated methodology groups have emerged in mid-size and large pharmaceutical companies and CROs. Their remit is to lead the conception and implementation of innovative quantitative methodologies in order to improve drug development, often by addressing complexities or offering more efficient designs. To achieve this, they collaborate internally and externally (e.g., with academics, regulators) to identify common challenges and tear down silos in order to invest in methods with the highest impact on efficiency and value to the portfolio. Given the immense financial stakes of drug development -- where delays carry massive implications -- these groups represent a critical strategic investment. However, to realize this business impact, statistical innovations must be rigorously validated and seamlessly integrated. This manuscript explores the setup, remit, and value of dedicated methodology groups, alongside the critical organizational considerations and success factors required to maximize their impact on the speed, efficiency, and probability of success.

stat.OT↗

arXiv2023

Sensitivity analysis for causality in observational studies for regulatory science

Recognizing the importance of real-world data (RWD) for regulatory purposes, the United States (US) Congress passed the 21st Century Cures Act1 mandating the development of Food and Drug Administration (FDA) guidance on regulatory use of real-world evidence. The Forum on the Integration of Observational and Randomized Data (FIORD) conducted a meeting bringing together various stakeholder groups to build consensus around best practices for the use of RWD to support regulatory science. Our companion paper describes in detail the context and discussion carried out in the meeting, which includes a recommendation to use a causal roadmap for complete pre-specification of study designs using RWD. This article discusses one step of the roadmap: the specification of a procedure for sensitivity analysis, defined as a procedure for testing the robustness of substantive conclusions to violations of assumptions made in the causal roadmap. We include a worked-out example of a sensitivity analysis from a RWD study on the effectiveness of Nifurtimox in treating Chagas disease, as well as an overview of various methods available for sensitivity analysis in causal inference, emphasizing practical considerations on their use for regulatory purposes.

stat.AP↗

arXiv2023

A Causal Roadmap for Generating High-Quality Real-World Evidence

Increasing emphasis on the use of real-world evidence (RWE) to support clinical policy and regulatory decision-making has led to a proliferation of guidance, advice, and frameworks from regulatory agencies, academia, professional societies, and industry. A broad spectrum of studies use real-world data (RWD) to produce RWE, ranging from randomized controlled trials with outcomes assessed using RWD to fully observational studies. Yet many RWE study proposals lack sufficient detail to evaluate adequacy, and many analyses of RWD suffer from implausible assumptions, other methodological flaws, or inappropriate interpretations. The Causal Roadmap is an explicit, itemized, iterative process that guides investigators to pre-specify analytic study designs; it addresses a wide range of guidance within a single framework. By requiring transparent evaluation of causal assumptions and facilitating objective comparisons of design and analysis choices based on pre-specified criteria, the Roadmap can help investigators to evaluate the quality of evidence that a given study is likely to produce, specify a study to generate high-quality RWE, and communicate effectively with regulatory agencies and other stakeholders. This paper aims to disseminate and extend the Causal Roadmap framework for use by clinical and translational researchers, with companion papers demonstrating application of the Causal Roadmap for specific use cases.

stat.ME↗