scholarly journals Sample size considerations for stratified cluster randomization design with binary outcomes and varying cluster size

2019 ◽  
Author(s):  
Xiaohan Xu ◽  
Hong Zhu ◽  
Chul Ahn
Keyword(s):  
Sample Size ◽  
Cluster Size ◽  
Binary Outcomes ◽  
Cluster Randomization

Alternative models and randomization techniques for Bayesian response-adaptive randomization with binary outcomes

2021 ◽  
pp. 174077452110101
Author(s):  
Jennifer Proper ◽  
John Connett ◽  
Thomas Murray
Keyword(s):  
Logistic Regression ◽  
Sample Size ◽  
Error Rate ◽  
Adaptive Design ◽  
Type I Error ◽  
Probability Model ◽  
Binary Outcomes ◽  
Type I ◽  
Operating Characteristics ◽  
Type I Error Rate

Background: Bayesian response-adaptive designs, which data adaptively alter the allocation ratio in favor of the better performing treatment, are often criticized for engendering a non-trivial probability of a subject imbalance in favor of the inferior treatment, inflating type I error rate, and increasing sample size requirements. The implementation of these designs using the Thompson sampling methods has generally assumed a simple beta-binomial probability model in the literature; however, the effect of these choices on the resulting design operating characteristics relative to other reasonable alternatives has not been fully examined. Motivated by the Advanced R2 Eperfusion STrategies for Refractory Cardiac Arrest trial, we posit that a logistic probability model coupled with an urn or permuted block randomization method will alleviate some of the practical limitations engendered by the conventional implementation of a two-arm Bayesian response-adaptive design with binary outcomes. In this article, we discuss up to what extent this solution works and when it does not. Methods: A computer simulation study was performed to evaluate the relative merits of a Bayesian response-adaptive design for the Advanced R2 Eperfusion STrategies for Refractory Cardiac Arrest trial using the Thompson sampling methods based on a logistic regression probability model coupled with either an urn or permuted block randomization method that limits deviations from the evolving target allocation ratio. The different implementations of the response-adaptive design were evaluated for type I error rate control across various null response rates and power, among other performance metrics. Results: The logistic regression probability model engenders smaller average sample sizes with similar power, better control over type I error rate, and more favorable treatment arm sample size distributions than the conventional beta-binomial probability model, and designs using the alternative randomization methods have a negligible chance of a sample size imbalance in the wrong direction. Conclusion: Pairing the logistic regression probability model with either of the alternative randomization methods results in a much improved response-adaptive design in regard to important operating characteristics, including type I error rate control and the risk of a sample size imbalance in favor of the inferior treatment.

Sample size estimation for modified Poisson analysis of cluster randomized trials with a binary outcome

2021 ◽  
pp. 096228022199041
Author(s):  
Fan Li ◽  
Guangyu Tong
Keyword(s):  
Relative Risk ◽  
Sample Size ◽  
Poisson Regression ◽  
Cluster Size ◽  
Randomized Trials ◽  
Cluster Randomized Trials ◽  
Binomial Regression ◽  
Size Variability ◽  
Working Correlation ◽  
Cluster Randomized

The modified Poisson regression coupled with a robust sandwich variance has become a viable alternative to log-binomial regression for estimating the marginal relative risk in cluster randomized trials. However, a corresponding sample size formula for relative risk regression via the modified Poisson model is currently not available for cluster randomized trials. Through analytical derivations, we show that there is no loss of asymptotic efficiency for estimating the marginal relative risk via the modified Poisson regression relative to the log-binomial regression. This finding holds both under the independence working correlation and under the exchangeable working correlation provided a simple modification is used to obtain the consistent intraclass correlation coefficient estimate. Therefore, the sample size formulas developed for log-binomial regression naturally apply to the modified Poisson regression in cluster randomized trials. We further extend the sample size formulas to accommodate variable cluster sizes. An extensive Monte Carlo simulation study is carried out to validate the proposed formulas. We find that the proposed formulas have satisfactory performance across a range of cluster size variability, as long as suitable finite-sample corrections are applied to the sandwich variance estimator and the number of clusters is at least 10. Our findings also suggest that the sample size estimate under the exchangeable working correlation is more robust to cluster size variability, and recommend the use of an exchangeable working correlation over an independence working correlation for both design and analysis. The proposed sample size formulas are illustrated using the Stop Colorectal Cancer (STOP CRC) trial.

A comparison of methods for sample size estimation for non-inferiority studies with binary outcomes

2010 ◽  
Vol 20 (6) ◽  
pp. 595-612 ◽  
Author(s):  
Steven A Julious ◽  
Roger J Owen
Keyword(s):  
Sample Size ◽  
Bayesian Methods ◽  
Sensitivity Analyses ◽  
Binary Outcomes ◽  
Sample Size Estimation ◽  
Controlled Trials ◽  
Comparison Of Methods ◽  
Size Estimation ◽  
Control Response ◽  
Established Treatment

Non-inferiority trials are motivated in the context of clinical research where a proven active treatment exists and placebo-controlled trials are no longer acceptable for ethical reasons. Instead, active-controlled trials are conducted where a treatment is compared to an established treatment with the objective of demonstrating that it is non-inferior to this treatment. We review and compare the methodologies for calculating sample sizes and suggest appropriate methods to use. We demonstrate how the simplest method of using the anticipated response is predominantly consistent with simulations. In the context of trials with binary outcomes with expected high proportions of positive responses, we show how the sample size is quite sensitive to assumptions about the control response. We recommend when designing such a study that sensitivity analyses be performed with respect to the underlying assumptions and that the Bayesian methods described in this article be adopted to assess sample size.

scholarly journals A new dependence parameter approach to improve the design of cluster randomized trials with binary outcomes

2011 ◽  
Vol 8 (6) ◽  
pp. 687-698 ◽  
Author(s):  
Catherine M Crespi ◽  
Weng Kee Wong ◽  
Sheng Wu
Keyword(s):  
Sample Size ◽  
Randomized Trials ◽  
Pearson Correlation ◽  
Sample Size Determination ◽  
Binary Outcomes ◽  
Alternative Measure ◽  
Cluster Randomized Trials ◽  
Sample Size Calculations ◽  
Cluster Randomized ◽  
Measure Of Dependence

Background and Purpose Power and sample size calculations for cluster randomized trials require prediction of the degree of correlation that will be realized among outcomes of participants in the same cluster. This correlation is typically quantified as the intraclass correlation coefficient (ICC), defined as the Pearson correlation between two members of the same cluster or proportion of the total variance attributable to variance between clusters. It is widely known but perhaps not fully appreciated that for binary outcomes, the ICC is a function of outcome prevalence. Hence, the ICC and the outcome prevalence are intrinsically related, making the ICC poorly generalizable across study conditions and between studies with different outcome prevalences. Methods We use a simple parametrization of the ICC that aims to isolate that part of the ICC that measures dependence among responses within a cluster from the outcome prevalence. We incorporate this parametrization into sample size calculations for cluster randomized trials and compare our method to the traditional approach using the ICC. Results Our dependence parameter, R, may be less influenced by outcome prevalence and has an intuitive meaning that facilitates interpretation. Estimates of R from previous studies can be obtained using simple statistics. Comparison of methods showed that the traditional ICC approach to sample size determination tends to overpower studies under many scenarios, calling for more clusters than truly required. Limitations The methods are developed for equal-sized clusters, whereas cluster size may vary in practice. Conclusions The dependence parameter R is an alternative measure of dependence among binary outcomes in cluster randomized trials that has a number of advantages over the ICC.

scholarly journals Sample size calculations for time-averaged difference of longitudinal binary outcomes

2016 ◽  
Vol 46 (1) ◽  
pp. 344-353 ◽  
Author(s):  
Ying Lou ◽  
Jing Cao ◽  
Song Zhang ◽  
Chul Ahn
Keyword(s):  
Sample Size ◽  
Binary Outcomes ◽  
Sample Size Calculations

scholarly journals Sample size requirements for pilot randomised controlled trials with binary outcomes: a simulation study

Trials ◽  
2013 ◽  
Vol 14 (Suppl 1) ◽  
pp. O21
Author(s):  
Dawn Teare ◽  
Munya Dimairo ◽  
Alexandra Hayman ◽  
Neil Shephard ◽  
Amy Whitehead ◽  
...  
Keyword(s):  
Sample Size ◽  
Simulation Study ◽  
Randomised Controlled Trials ◽  
Binary Outcomes ◽  
Controlled Trials ◽  
Randomised Controlled
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